Nevada Administrative Code
Chapter 693A - Corporate Powers and Procedures of Domestic Stock and Mutual Insurers
PROXY SOLICITATIONS FOR ELECTION CONTESTS
Section 693A.560 - Signature of statements

The statement must be dated and signed in substantially the following manner:

I certify that all the information contained in this statement is true, complete and correct, to the best of my knowledge and belief.

................................................................. ...........................................................

(Date) (Signature of participant or authorized representative)

Comm'r of Insurance, Schedule B item 5, eff. 5-13-72

NRS 679B.130