FRAUD WARNING – Pursuant to California Insurance Code Section 1879.2:

For the your protection California law requires the following to appear on this form. Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. 

 

FRAUD NOTICE – Pursuant to Arizona Revised Statute 20-466.03:

For your protection Arizona law requires the following statement to appear on this form.  Any person who knowingly presents a false or fraudulent claim for payment of a loss is subject to criminal and civil penalties.