MWCIA - Circular 07-1521 - Amended Minnesota Statute 60A.351
Effective August XX, 2007
MINNESOTA POLICY INFORMATION PAGE ENDORSEMENT
CLASS, RATE, OTHER CHANGE
This endorsement changes the policy to which it is attached and is effective on the date... Expiration Date:
Premium (If any)
Authorized Representative
Item 4. Class, Rate, Other:
Classifications
Code
No.
Premium Basis
Total Estimated
Annual
Remuneration