Document 85qq3z21B4GQGO8p5mvwz9kp5

Mo' I SjL! ------ j sA^cC -tAS<- ----/L, ~ ~tfC. //o A*. % ! r <jatta&anel ~SLZ&&. ldthoJtaly 1991. X la lnKruoted toy tbi widow and dependents oflfthe late Hobert Kershaw to applyJto yon for paywent of ooBpeneatlon lnespeot of tola death* and 1 should towotollgid If yon would pat bo In touota lift y*ntInsurance Coupany iso that the nassssli^Ppartloulare nay be supplied t# then. fours faithfully. TN 4556 / - * r*3,n -t