FOIA
LETTER TO WILLIAM R. ABRUSCATO FROM JAMES E. MEALS RE NOTICES OF CONVERSION RIGHT UNDER GROUP LIFE INSURANCE POLICY ISSUED TO COCCHI, M. C.
Document Type:
Keywords:
Collection:
Document Number (FOIA) /ESDN (CREST):
0001451911
Release Decision:
RIFPUB
Original Classification:
U
Document Page Count:
2
Document Creation Date:
June 22, 2015
Document Release Date:
March 26, 2008
Sequence Number:
Case Number:
F-2006-00733
Publication Date:
March 29, 1973
File:
| Attachment | Size |
|---|---|
 DOC_0001451911.pdf | 66.3 KB |
Body:
1725 K STREET, N.W.
WASHINGTON, D.C. 20006
APPROVED FOR RELEASE
DATE: JAN 2008
CABLE ADDRESS
AIRAMERICA
March 29, 1973
Mr. William R. Abruscato
Group Administrator
American International Life
Assurance Company of New York
102 Maiden Lane
New York, N. Y. 10005
Enclosed please find copies of Notices of Conversion Right under Group
Life Insurance Policy issued to the following personnel listed below.
1.
Arnesan, R.
10.
Johnson, W. L.
1.
Bonansinga, F. C.
11.
Purvis, M. R.
Cocchi, M. C.
12.
Reimer, E. C.
4.
Cook, R. K.
13.
Reynolds, G. L.
5.
Dunn, T. T.
14.
Ruck, B. J.
6.
Elder, R. W.
15.
Seethaler, K. H.
7.
Fraser, D. L.
16.
Toman, G. J.
8.
Gamelin, D. V.
17.
Trowbridge, T. J.
9.
Henthorn, D. G.
Sincerely,
James E. Meals
Assistant.Vice President
NOTICE OF CONVERSION RIGHT UNDER GROUP LIFE INSURANCE POLICY
issued by
AM RICAN INTERNATIONAL LIFE ASSURANCE COMPANY
OF NEW YORK
IN TSE CITY OF NEW YORK
102 Maiden Lane, New York. N. Y. 10005
To: .............._ < .... ` ~ PFD 2~ hZoulton Hill Pd. Monson, Mass
-------------- -
Name of Employee 01108
~ Your employment with the undersigned having terminated, effective
........ ----------- 1 .~ ........ __.., you are hereby notified in accordance
with Subdivision 3 of Secti n 204 of Chapter 28 of the Consolidated Laws of New York that under
the terms of the Group Life Policy issued by American International Life Assurance Company of
New York to the undersigned, you may convert your Life Insurance coverage under said Policy,
evidenced by your Certificate, to an individual policy of Life or Endowment Insurance, preceded by
(at the option of the insured) a Single Premium Interim Term policy of one year only by raking
application therefor to said American International Life Assurance Company of New York at its
Home Office in New York, N. Y. Such application must be made within thirty-one days after the
date of the termination of your employment or within fifteen days from the date of the giving of
this notice, if said date is more than fifteen days, but less than ninety days after the date of said
termination, and upon complying with all the other terms and conditions set forth in said Group
Name of Employer Group Policy No.
INSTRUCTIONS TO POLICYHOLDER
This notice must be completed in duplicate and the original furnished to each individual upon termina-
tion of the individual's insurance due to termination of employment or upon cessation of active work
in accordance with your pension or retirement plan. The duplicate copy should be sent to us with the
following information :
Employee's Certificate No ................................. Original Effective Date of Insurance...-..1/1/71
Amount of Insurance at Time of Termination $._ 33a SOO.OO Date of Birth ....... 5/28/0
Completed by ----------- ME-3B
name and title
Mail This Coley To:
AMERICAN INTERNATIONAL LIFE ASSURANCE COMPANY OF NEW YORK
in the City of New York
GROUP O SION
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