ARE YOU NOW THE SUBJECT OF ANY COMPLAINT INVESTIGATION OR PROCEEDING THAT COULD RESULT IN A YES ANSWER TO ANY OF THE PREVIOUS QUESTIONS REMARKS I HEREBY CERTIFY THAT ALL OF THE INFORMATION HEREIN IS ACCURATE AND COMPLETE. I ACKNOWLEDGE AND AGREE THAT MY APPOINTMENT WILL IN PART BE BASED ON THIS PRODUCER APPOINTMENT FORM AND BACKGROUND INFORMATION AND ANY FALSIFICATION MISREPRESENTATION OR OMISSION OF INFORMATION FROM THIS FORM MAY RESULT IN THE WITHHOLDING OR WITHDRAWAL OF ANY OFFER OF...
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