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Directory Results for Financial Affairs Division Arizona Department of Insurance 2910 North 44th Street, Suite 210 Phoenix, Arizona 850187269 Telephone: (602) 3643999/Fax: (602) 3643989 APPLICATION FOR REINSURER MAINTAINING SURPLUS A to Financial Affairs Division Arizona Department of Insurance 2910 North 44th Street, Suite 210 Phoenix, Arizona 850187269 Telephone: (602) 3643999/Fax: (602) 3643989 POWER OF ATTORNEY AND CERTIFICATE OF ASSUMING INSURER I, , (name of officer)

Financial Affairs Division Arizona Department of Insurance 2910 North 44th Street, Suite 210 Phoenix, Arizona 850187269 Telephone: (602) 3643999/Fax: (602) 3643989 APPLICATION FOR REINSURER MAINTAINING SURPLUS A
Financial Affairs Division Arizona Department of Insurance 2910 North 44th Street, Suite 210 Phoenix, Arizona 850187269 Telephone: (602) 3643999/Fax: (602) 3643989 POWER OF ATTORNEY AND CERTIFICATE OF ASSUMING INSURER I, , (name of officer)