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Shall be assessed to its members in accordance with the methodology set forth in Indiana Code, as amended. Indiana Code 27-8-10-2.1(e)(2) gives the Association the authority to take any legal actions necessary to collect assessments from members. You are required to complete the following Supplement Form and return it to the address listed below by March 1, 2010, even if your company has nothing to report for the calendar year indicated. Company Information: NAIC #: Company Name: Company Addr.

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