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OCR Page 1 of 2Please bring this Notice when you pay the Premium. Notify me promptly whenever your address
is changed. Always give Policy number when writing me concerning your insurance.
The Mutual Life Insurance Company of New York,
Goo p gates
300 North Fourth Street, St. Louis, Mo.
Indep me
KCB
The Premium on your Policy No.
170048 $ 15600
will be due on the
2
7 day of. Sept 1886
NARA
Yours respectfully,
BYRON SHERMAN,
General Agent.
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