<<Agncy_Name>>
<<Agncy_Address>>
<<Agncy_City>>, <<Agncy_State>>  <<Agncy_Zip>>
 
Phone:<<Agncy_Phone>>  |  Fax: <<Agncy_Fax>> 

<<Today>>

<<Cli_First>> <<Cli_Last>>
<<Cli_Address>>
<<Cli_City>>, <<Cli_State>> <<Cli_Zip>>

RE: <<Pol_LOBDescriptions>>
Carrier: <<Pol_CompanyUnique>>
Policy Number: <<Pol_PolNum>>

Dear <<Cli_Preferred1>>:
 
Please sign the attached application and return for our files.

Sincerely,

<<User Name>>
<<User_Notes>>
<<User_Email>>