NOTICE OF CANCELLATION OF POLICY
:>THERHOOD Nt' ',TUAL
INSURANCE ANY
lOX 2227 . FORT WAYNE, IN, , ~ .46801
NOTICE OF
C~NCELlATION OF pnLtrv
~
RAl,] Ct<EWS INSURANCE (NC
Fl 33563
YOU ARE HEREBY NOTIFIED THAT
WITH THE TERMS Of YOUR POlIC
INSURANCE CEASES AT THE HOUR
THE POLICY ON 4/21/85.
: CH~ISTIAN
YOUR REQUEST
,EARWAT'::R
FL 331)18
VICE PRESIDI
MORTGAGEE'S COPY
SIt.
POLICY NUMBER
BROTHERHOOD M' .pUAL
INSURANCE ANY
P.O, BOX 2227 . FORT WAYNE, IK ..46801
NOTICE OF
PAST DUE PR(MIlJ"'1
09t-15AO 165442
AGENT OOQ8 L GERALD CRHjS INSURANCE INC
COUNTRYS I OE CHRI ST IAN
CFNTER -INC
PO RnX 190
PALM HARBOR FL 33563
YOUR POLICY EXPIRED ON 4/21/85 DUE TO NON
PAYMENT OF PREMIUM. IT WILL BE PEINSTA~ED
WITH NO LAPSE IN COVERAGE If PAYMENT IS
RECEIVED IN OUR OFFICE flY 06/05/85.
'R E C flr'" ~'l)lT OF PRE~I UM
512.00
-CITY OF CLEARWATER
CLEAPWATER Fl ~3518
MAY 28 1985
a~
C cu
VICE PRESIDENT AND TREASURER
~\TGQhr;lf COpy
5/22/85