DECLARATIONS. By accepting this policy, you agree that all the statements in your application and the declarations are true and that you have provided us with all material information about your pet’s health. You agree that this policy and any endorsements or riders issued to you is the entire and only agreement between you and us.
DECLARATIONS. To make possible the fullest attainment of the above-stated objective, the following declarations shall apply:
DECLARATIONS. 1. Each State Party shall submit to the Secretary-General of the United Nations, not later than 30 days after this Treaty enters into force for that State Party, a declaration in which it shall:
DECLARATIONS. Each of the undersigned declares, understands and agrees that: - The answers provided above are complete and true to the best of his/her knowledge and belief. - If the answers to the Health Questions contained in this Agreement or the Application are incorrect, incomplete or untrue, the Company will have the right to deny benefits under this Agreement. X Date: ----------------------------------- ------------------------------ Proposed Primary Insured Signature X Date: ----------------------------------- ------------------------------ Proposed Policy Owner Signature (if other than the Proposed Insured) RECEIPT OF PAYMENT A premium payment of $ has been submitted with the Application or Request. Additional premium may be required upon Policy delivery. All premium checks must be made payable to Hartford Life Insurance Company or Hartford Life and Annuity Insurance Company. Do not make check(s) payable to the Agent or leave the payee blank. X Date: ----------------------------------- ------------------------------ Agent Signature DETACH OWNER'S COPY AT TIME OF APPLICATION HOME OFFICE COPY Allocated Retention. Pool -- Effective 10/1/2008 Between HLIC and TFLIC EXHIBIT VI CONDITIONAL RECEIPT OR TEMPORARY INSURANCE AGREEMENT EFFECTIVE OCTOBER 1, 2008 [LOGO] HARTFORD LIFE INSURANCE COMPANY THE HARTFORD HARTFORD LIFE AND ANNUITY INSURANCE COMPANY 500 BIELENBERG DRXXX, XXXXXXXX, XX 55125 P.O. BOX 64271, ST. PAUL, MN 55164-0200 TEMPORARY INSURANCE AGREEMENT PROPOSED PRIMARY INSURED: NAME: DATE OF BIRTH: Under this Temporary Insurance Agreement ("Agreement"), Hartford Life Insurance Company or Hartford Life and Annuity Insurance Company ("Company") agrees to provide a limited amount of life insurance coverage, for a limited period of time, subject to the terms and conditions set forth below. WHEN COVERAGE BEGINS Temporary life insurance coverage under the Agreement becomes effective on the date this Agreement is signed, subject to ALL of the following conditions:
DECLARATIONS. If requested by Landlord at any time during the Term, Tenant promptly will execute a declaration in the form attached hereto as Exhibit B.
DECLARATIONS. Each of the undersigned declares, understands and agrees that: - The answers provided above are complete and true to the best of his/her knowledge and belief. - If the answers to the Health Questions contained in this Agreement or the Application are incorrect, incomplete or untrue, the Company will have the right to deny benefits under this Agreement. X Date: ----------------------------------- ------------------------------ Proposed Primary Insured Signature X Date: ----------------------------------- ------------------------------ Proposed Policy Owner Signature (if other than the Proposed Insured) RECEIPT OF PAYMENT A premium payment of $ has been submitted with the Application or Request. Additional premium may be required upon Policy delivery. All premium checks must be made payable to Hartford Life Insurance Company or Hartford Life and Annuity Insurance Company. Do not make check(s) payable to the Agent or leave the payee blank. X Date: ----------------------------------- ------------------------------ Agent Signature OWNER'S COPY Allocated Retention Pool (Excess Risks) -- Effective October 1, 2008 Between HLIC and Canada Life 104 EXHIBIT VII REINSURANCE REPORTS EFFECTIVE OCTOBER 1, 2008
DECLARATIONS. Accuracy of information Subscription Agreement, Issuing Document and Articles of Association I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have read, agreed and understood the contents of this subscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the Beneficial Owner Capacity U.S. Distribution Transfer Restrictions Origin of funds Fax or other electronic transmission TAX Compliance application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have full legal capacity to subscribe in, hold and/or deal with the Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for the account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. I confirm that the monies invested do not originate directly or indirectly from illegal or criminal activities and more generally do not contravene to applicable anti-money laundering laws ...
DECLARATIONS. By acceptance of this policy the Named Insured agrees that the statements in the Declarations are his agreements and representations, that this policy is issued in reliance upon the truth of such representations and that this policy embodies all agreements existing between himself and the Company or any of its agents relating to this Insurance.
DECLARATIONS. 4.1. In case the Customer is an individual who signs the mandate as the Customer’s representative also personally provides the declarations, confirmations and guarantees of the Customer and is personally bound due to this. He also declares that he has full authority to contract and perform FX Transactions, has received the required authorizations and has proceeded with all the actions that are necessary for the undertaking and the fulfillment of the obligations under the FX Transactions Terms.
DECLARATIONS. The Declarations to this Agreement shall form an integral part of this Agreement.
