lable) 2. Oiling Typo 0 Pre-Authorized Check IPAQ isidual OLIO« Bill Grays Bal (pray:de I mc/Fran /) i Speedy Pal:cy Dale 1021uthen Issue On COWILETE MS SECTION FUR ALL CASES 4. Oats PolcY to sew age for l:I Insured 1 [) In stared 2 5. Has Crafted° pier-in teen paid/ D yes ais'.. ci a Yes. C