Guarantee Reserve Life Ins. Co. of Hammond

Front:
PREMIUM RECEIPT We hereby acknowledge receipt of the payment of the amount recorded on the re- verse side and agree to insure the person to whom this is addressed in accordance with the terms and conditions of the Policy, as numbered on this receipt, until the date shown on reverse side. PLEASE NOTE IF GIVEN IN EXCHANGE FOR CHECK OR DRAFT WHICH IS NOT HONORED UPON PRESENTATION, THIS RECEIPT SHALL BE VOID 7. Kutah J. F. KUTAK President J. GUARANTEE RESERVE LIFE INSURANCE COMPANY OF HAMMOND HAMMOND, INDIANA This Receipt also used for Policy Holders formerly with National Protective Insurance Company and Safety Drivers Insurance Corporation. Ox PQ

Back:
GUARANTEE RESERVE LIFE INS. CO. OF HAMMOND HAMMOND, INDIANA Return postage guaranteed if not delivered in 5 days. POLICY NUMBER ol PAID TO C 189 33 40 POLLARD, MARY 61057 F-341-A VH IND: AMOND MAY 6 5 30 PM 1957 12.5 UNTERS PRAY PEACE POSTAL CARD 302 E COLLEDGE ST CANONSBURG PA