MAIPF

Ballot for Bulletin Number 162
36th Annual Meeting - Election of MAIPF Board of Governors
Bulletin 162 | 2007 Vote Weights | Ballot/Proxy
Online Voting Deadline is May 22, 2007.

Please record our company weighted vote as follows:  
Allstate Amerisure Auto-Owners Auto Club  
Citizens Hastings State Farm   9/7/2010
Name:  
Title:  
Completed by:  
Member Company Name:  
Vote Weight:  
Direct Premiums Written:  
Phone Number:  
E-mail Address:  
Please note any change of name, address, ownership or status:  
Submit one ballot for each company.
If you have any problems with this form, please call 734.464.1100 x 222 or send an e-mail message.

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