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AGENT COUNTERSIGNATUREThe signature shown below complies with the countersignature laws and regulations of the State shown: Policy Number: EPPE29562605 State: FL Named Insured: Harborside Terrace

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Wisconsin Legislature INS 849 refers to a specific form used for reporting certain administrative or legislative information as mandated by Wisconsin state laws.

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The form typically requires information such as the reporting entity's name, address, relevant financial data, and details pertaining to legislative compliance.

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