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By signing below, I acknowledge that: I am 18 years of age or older, and I agree to register for Protection Plus, and I acknowledge that I have read, understood and agree to the Terms and Conditions. I hereby authorize Protection Plus' administrator, NBFSA, to charge me the amount listed above for the contracts listed above. I understand that this authority shall remain in force until I notify Protection Plus' administrator in writing of its cancellation. I have read, understood and verify the accuracy of the information provided.

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