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Beneficiary Designation Form - Colonial Voluntary Benefits

The Paul Revere Life Insurance Company CLAIMS AUTHORIZATION FAX: 1-800-880-9325 Telephone: 1-800-325-4368 Authorization for The Paul Revere Life Insurance Company For the purpose of evaluating my eligibility for insurance and eligibility

Fax to: Claims 1

Download Form #100694 - Colonial-paulrevere.com

100986-1-NY.doc

Download Form #97939 - Colonial-paulrevere.com

Paul Revere Life Insurance Company SOLICITUD DE SERVICIO: Qu tipo de servicio est solicitando

The Paul Revere Life Insurance Company AUTORIZACI N PARA RECLAMACIONES FAX: 1-800-880-9325 Telephone: 1-800-325-4368 Autorizaci n para la compa a The Paul Revere Life Insurance Con el prop sito de evaluar mi elegibilidad para seguros y para

97941-2-SP.docx

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