v2706-327

28

rt-4:iAJ. L L

(St.iI.pNam. of c.r.i^AKt or Branch oc.fc'^^^ * *'. Date Received at If fl^R ( N G F " T AUG 4

iMARYfcAND CASUALTY COMPANY TEXAS STANoJb automobile app P"^

DECLARATIONS

Harold .. Ka

Bcacwal mt 1km

i 3 48 1 f-lg

4a Ti8^g?iriildr.., Dallaa, Dtellaa, T*

T*wa or Qtr "

The B.Ded in.ured i. ^^ Vidu* ,

dadlTidiuJ, eocponltaa, w i '

itmm 2. Policy Pariod: Fr._ ^, .

Standard Time at the addren ot,^^named i

''" 3. . .

Hone Office Reins. _^ .

Ujo Only Ceded ""* " =^

to

itioiA.li, cn

COVERAOBS

A-Bly UMniy LlaMUtr

LIMITf OP LIABILITY ^G^OOOOa.d, pe,.

t 50,QC)Q^0a.d, cuta.tj.t 5,0(X)#(

dent t 500Q0 eaek^MM

1B00

ig prt of the poUcT o In cSectiTe data

roiY.i i,'15Q attached

to nril 1 r-v- x

argeaa oer endoncmeBt attached

Total PrMniam

1. The purposes for whlchWrt^obUe U to be ued are raOOOUTa OIlU DUfllZMOfl

2. The rilk wa insured durinc the paat year t

BSIB''i^''-'^'-^""-'^^^

Io ^^::coJtlol:

r.i.e Code No. ud Stmt) ^^

PASTE AU Er

ENTS ON BACK

I052. Edition July 19i6 (Tcxhs)

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