Front:
限ST
EXCLUSIVE HEALTH &
ACCIDENT COMPAN
Official Receipt for Premium Due
IN THE WORLD
April 1, 1947
This is an acknowledgment to the member to whom this card is addressed, of the
receipt on this date of premium in the amount, and on the policy designated on the
opposite side hereof. If given in exchange for check or draft which is not honored upon
presentation, this receipt and any renewal or reinstatement of the policy evidenced hereby
shall be void. File this receipt with your policy for future reference. Your address upon
our records is the same as indicated upon the opposite side of this card. If you change
your address or occupation, notify the Association.
Payment of this premium receipted for, if made on or before the date to which
premiums have already been paid, keeps your policy in continuous effect, and if made after
that date, reinstates the policy on date of this receipt, as provided in policy, until 12 o'clock
noon, standard time, July 1, 1947, at which time another premium will be due.
Payment received and receipt
countersigned.----
---
--MAR-1947-
(Date)
E. B. BRINK AGCY
By---
Local Treasurer.
M654
President.
Back:
MUTUAL., BENEFITS
HEALTH AND ACCIDENT
ASSOCIATION
LETRO,
APR 1'47
MICH;
kom:
01:
METER
P.B.109361
*****
53GHS-349944-46M
10.95
MRS. LILLIAN A. WINEGAR,
8971 SHELBY RD., RFD 1, BOX !
ROCHESTER, MICH.
