"IF YOU SIGN THIS RELEASE YOU MAY FORFEIT YOUR RIGHT TO UNINSURED MOTORIST INSURANCE BENEFITS FROM YOUR OWN AUTOMOBILE INSURANCE POLICY. CONSULT WITH YOUR INSURANCE AGENT, YOUR AUTOMOBILE INSURANCE COMPANY, OR YOUR ATTORNEY BEFORE SIGNING."
I certify that I have read the above warning and fully understand it.
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Signature |
RSA 264:15
RSA 268:15-a. 1967, 284:2. 1969, 418:1; 485:1, 2. 1970, 37:11. 1981, 146:1; 507:3, 7. 1988, 77:2. 1991, 330:2. 2000, 324:1. 2007, 302 : 1 . 2009, 74 : 1 , eff. Jan. 1, 2010. 2015, 237 : 1 , eff. Sept. 11, 2015.