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Disclosure of Broker Status
May 05th, 2009
The Disclosure of Broker Status form is used to comply with California Insurance Code 1623 and can be used as page 1 of your Broker Fee Disclosure form. Your agency name should be inserted where shown.
Disclaimer: This is a sample form and may not be suitable for your useage. We ask that you consult with your attorney or other legal adviser before using this form.
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