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4100.XXX
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1991-06-27
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515b
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18 lines
#4100
@001 Please state the name of the owner of the property(lender):
@002 Please state the name of the borrower of the property:
@410 Please describe the property lent:
@411 Please state length of loan:
@412 Please state purpose of borrowing:
#4101/#4102/ The property will be insured:
By the owner
By the borrower
By neither, or contract does not state
#if#4102
@419/@419 State required limits of insurance:
$ 500,000
KEY IN VALUE
#endif
#4103 Do you desire to have an indemnity clause?
#4104