I certify under penalty of perjury and pursuant to the laws of Iowa that, on (date of mailing),
I mailed copies of (describe document) addressed to the Insurance Division at the address disclosed in 191-1.4 (502,505) and to the names and addresses of the parties listed below by depositing the same in (a United States post office mailbox with correct postage properly affixed or state interoffice mail). I emailed copies of (describe document) addressed to the Insurance Division at the email address disclosed in subrule 3.12(4) and to the names and email addresses of the parties listed below by transmitting the same from (sending email address).
(Date) (Signature)
Iowa Admin. Code r. 191-3.12