Free Other Notice - District Court of Arizona - Arizona


File Size: 21.1 kB
Pages: 1
Date: December 31, 1969
File Format: PDF
State: Arizona
Category: District Court of Arizona
Author: unknown
Word Count: 145 Words, 865 Characters
Page Size: Letter (8 1/2" x 11")
URL

https://www.findforms.com/pdf_files/azd/43431/131-2.pdf

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DECLARATION
Cheryl Sauerhoff, upon het oath, states as follows:
1. I am an Appeal Team Leader with Hartford Life and Accident Insurance I
Company.
2. I am the agent for Hartford Life and Accident Insurance Company for the
purpose of authenticating the ERISA claim tile relating to the claim made by Constance
Maynard on policy no. SR83 100971, issued by Continental Casualty Company.
3. To the best of my knowledge, inforrnatiou and belief, Bates Nos. GKCNA-
CM00001—1371 comprises a true and correct copy ofthe ERISA claim file on Ms
Maynard’s claim.
4. I declare under penalty of peijury that the foregoing is tmc and correct.
DATED this 1** day of August, 2008.
<.-;§;;4,u.¤.»L»
Case 2:04-cv-00525-RCB Document 131 -2 Filed 08/01 /2008 Page 1 of 1

Case 2:04-cv-00525-RCB

Document 131-2

Filed 08/01/2008

Page 1 of 1