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Documents  »  Release And Trust Agreement (UM/UIM PD)
Release And Trust Agreement (UM/UIM PD)
Release And Trust Agreement (UM/UIM PD)
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Form 1060F© 2003 Nationwide Publishing Company, Inc.http://www.claimspages.comRELEASE AND TRUST AGREEMENTUninsured / Underinsured Motorist CoveragePROPERTY DAMAGE ONLYI/we, for the sole consideration of dollars ($) to be paid by, hereinafter calledthe Company, the undersigned in his/her/their capacity as insured(s), and/or as parent(s) or guardian(s) of aminor , and/or as spouse or legal representative(s)of a deceased insured , do hereby forever discharge andrelease the Company from any and all claims, actions, causes of action, demands, rights,...
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ACUERDO DE LIBERACIÓN Y FIDEICOMISO Cobertura de motorista no asegurado o infrasegurado POR DAÑOS MATERIALES ÚNICAMENTE Por el pago de una contraprestación única de dólares ($) que entregará (en adelante la Compañía), el (los) suscrito(s) del presente acuerdo en calidad de asegurado(s), y/o padre(s) o tutor(es) de el(la)l menor ,...
A release form signed by an insured when making an uninsured motorist or underinsured motorist claim. Requires the insured to cooperate in the recovery of funds from the responsible party.
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District of Columbia - Traffic Crash Report: PD 10 (7/03)
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