Common use of Agent Affirmation Clause in Contracts

Agent Affirmation. You must complete and sign this form before you submit it to an insurance company as proof that you have completed training. Section Four – Training program Content and Affirmation (Insurance Companies, Banks, and Broker- Dealers Only) If the training was delivered by an insurance company, bank, or broker-dealer, that entity must either provide a certificate (including an outline of the training program) or complete Section Four, certifying that the training program covers the ACLI’s “Recommended Core Elements for an AML Training Program for Life Insurance Agents and Brokers” and/or that the training program is in Compliance with regulations issued under the USA PATRIOT Act. The ACLI Core Elements are posted on the internet at the following site: xxxx://xxx.xxxx.xxx/ACLI/Issues+nonmembers/AML+Resources%3a+Integrating+Agents+and+Brokers.htm If the training was delivered by an insurance company, broker-dealer, or bank, this form will not be accepted unless the firm performing the training provides a certificate of completion or executes this affirmation. Insurance companies, broker-dealers and banks are subject to AML requirements imposed by regulations issued under Section 352 of the USA Patriot Act (31 CFR 103.137 and/or NASD Rule 3011). If your training was provided by a vendor or an entity not subject to these regulations, the insurance company you represent will need to verify the content of the training. Contact Information

Agent Affirmation. You must complete and sign this form before you submit it to an insurance company as proof that you have completed training. Section Four – Training program Content and Affirmation (Insurance Companies, Banks, and Broker- Dealers Only) If the training was delivered by an insurance company, bank, or broker-dealer, that entity must either provide a certificate (including an outline of the training program) or complete Section Four, certifying that the training program covers the ACLI’s “Recommended Core Elements for an AML Training Program for Life Insurance Agents and Brokers” and/or that the training program is in Compliance with regulations issued under the USA PATRIOT Act. The ACLI Core Elements are posted on the internet at the following site: xxxx://xxx.xxxx.xxx/ACLI/Issues+nonmembers/AML+Resources%3a+Integrating+Agents+and+Brokers.htm If the training was delivered by an insurance company, broker-dealer, or bank, this form will not be accepted unless the firm performing the training provides a certificate of completion or executes this affirmation. Insurance companies, broker-dealers and banks are subject to AML requirements imposed by regulations issued under Section 352 of the USA Patriot Act (31 CFR 103.137 and/or NASD Rule 3011). If your training was provided by a vendor or an entity not subject to these regulations, the insurance company you represent will need to verify the content of the training. Contact InformationInformation If you have any questions, please contact your AML Officer. Form CA-2006-1

Agent Affirmation. You must complete and sign this form before you submit it to an insurance company as proof that you have completed training. Section Four – Training program Content and Affirmation (Insurance Companies, Banks, and Broker- Dealers Only) If the training was delivered by an insurance company, bank, or broker-dealer, that entity must either provide a certificate (including an outline of the training program) or complete Section Four, certifying that the training program covers the ACLI’s “Recommended Core Elements for an AML Training Program for Life Insurance Agents and Brokers” and/or that the training program is in Compliance with regulations issued under the USA PATRIOT Act. The ACLI Core Elements are posted on the internet at the following site: xxxx://xxx.xxxx.xxx/ACLI/Issues+nonmembers/AML+Resources%3a+Integrating+Agents+and+Brokers.htm If the training was delivered by an insurance company, broker-dealer, or bank, this form will not be accepted unless the firm performing the training provides a certificate of completion or executes this affirmation. Insurance companies, broker-dealers and banks are subject to AML requirements imposed by regulations issued under Section 352 of the USA Patriot Act (31 CFR 103.137 and/or NASD Rule 3011). If your training was provided by a vendor or an entity not subject to these regulations, the insurance company you represent will need to verify the content of the training. Contact InformationInformation If you have any questions, please contact your AML Officer.

Agent Affirmation. You must complete and sign this form before you submit it to an insurance company as proof that you have completed training. Section Four – Training program Content and Affirmation (Insurance Companies, Banks, and Broker- Broker-Dealers Only) If the training was delivered by an insurance company, bank, or broker-dealer, that entity must either provide a certificate (including an outline of the training program) or complete Section Four, certifying that the training program covers the ACLI’s “Recommended Core Elements for an AML Training Program for Life Insurance Agents and Brokers” and/or that the training program is in Compliance with regulations issued under the USA PATRIOT Act. The ACLI Core Elements are posted on the internet at the following site: xxxx://xxx.xxxx.xxx/ACLI/Issues+nonmembers/AML+Resources%3a+Integrating+Agents+and+Brokers.htm If the training was delivered by an insurance company, broker-dealer, or bank, this form will not be accepted unless the firm performing the training provides a certificate of completion or executes this affirmation. Insurance companies, broker-dealers and banks are subject to AML requirements imposed by regulations issued under Section 352 of the USA Patriot Act (31 CFR 103.137 and/or NASD Rule 3011). If your training was provided by a vendor or an entity not subject to these regulations, the insurance company you represent will need to verify the content of the training. Contact InformationInformation If you have any questions, please contact your AML Officer. Statement of Policy on Producer Developed Advertising American National Life Insurance Company of Texas American National Life Insurance Company of Texas One Xxxxx Plaza, Galveston, TX 00000-0000 Phone Number: (000) 000-0000 Mailing Address: PO Box 1795 Galveston, TX 77550-1795 page 1 of 1