Ill. Admin. Code tit. 50, pt. 917, exh. B

Current through Register Vol. 48, No. 49, December 6, 2024

Exhibit B - Notice Regarding Proposed Replacement of Life Insurance or Annuity

(Name of Existing Insurer)

(Address)

(City, State, Zip Code)

(Salutation)

You are herewith given notice that we are in receipt of application(s) for life insurance or annuity(ies) for an individual presently insured with your company.

Identification

Name of Insured	_____________________
Address	_____________________
_____________________
Contract Number	_____________________	_____________________
" "	_____________________	_____________________
" "	_____________________	_____________________
" "	_____________________	_____________________

This notice is given pursuant to 50 Ill. Adm. Code 917.70(c)

____________________________	____________________________
(Insurance Producer's Signature)	(Closure)

Ill. Admin. Code tit. 50, pt. 917, exh. B