{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-4036","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-4036","heading":"Statement by applicant regarding notification of","body":"replacement to replaced insurer.\n\nThe statement referred to in the Life Insurance and Annuity\n\nPolicyholders Protection Act shall be delivered to the applicant for\n\na replacement life insurance policy or a replacement annuity policy\n\nalong with the notice provided for in Section 5 of the Life\n\nInsurance and Annuity Policyholders Protection Act. The legal name\n\nand address of the replacing insurer may be printed on the\n\nstatement. Said statement shall be in substance as follows:\n\nSTATEMENT BY APPLICANT REGARDING NOTIFICATION\n\nOF REPLACEMENT TO THE REPLACED INSURER\n\nI have read the \"NOTICE TO APPLICANTS REGARDING REPLACEMENT OF\n\nLIFE INSURANCE OR AN ANNUITY\" which was furnished to me by the agent\n\ntaking the application for this policy.\n\n(Applicant: Please sign ONE of the following statements.)\n\n1. Please notify my present insurer(s) regarding this\n\ntransaction.\n\n_______________________\n\n_______________________\n\n_\n\nDate Signature of Applicant\n\n2. Please do not notify my present insurer(s) regarding this\n\ntransaction.\n\n_______________________ ________________________\n\nDate Signature of\n\nApplicant\n\nThe signature of the applicant shall be that of the insured\n\nunless someone other than the insured is the owner of the policy. If\n\nsomeone other than the insured is the owner of the policy, the owner\n\nmust sign. If the insured is under eighteen (18) years of age, the\n\nparent is deemed to be the owner of the policy.\n\nCertification by the agent:\n\nI hereby certify that nothing was said or done during the sales\n\npresentation to influence the decision of the applicant regarding\n\nthis statement.\n\n________________________ _______________________\n\nDate Signature of Agent\n\n__________________________\n\nInsurance Agency or Agent\n\nLicense Number","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"9987cc2977577ab04f7c062819c478a04cf0e2176f61f16e5bec5468db69ec66","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-4035","next":"us-ok/okla.-stat.-tit.-36-36-4037"},"notice":"GroundRules: Original legal text. Not legal advice."}