The following disclosure form shall be utilized:
IMPORTANT NOTICE TO APPLICANTS REGARDING STUDENT LOANS OBTAINED THROUGH: ___________ Name of Insurance Company
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY:
I certify that I have read the above statements and that I understand my rights and privileges relative to the purchase of any insurance in connection with my student loan application.
____________________________
Signature of Insurance Applicant
____________________________
Date
Fla. Admin. Code Ann. R. 69O-124.024
Rulemaking Authority 624.308(1) FS. Law Implemented 624.307(1), 626.9541(1)(a), 626.9551(1)(a) FS.
New 11-24-85, Formerly 4-64.04, 4-64.004, 4-124.024.