34 BULLETIN 530, U. S. DEPARTMENT OF AGRICULTURE. 



Form for assignment, t<> go on policy: 



Notice. — No assignment of this policy shall be valid until approved by the 

 company. 



Assignment. 



For value received, I hereby transfer, assign, and set over unto 



and assigns all my rights, title, and interest in this Policy of In- 

 surance, and all benefit and advantage to be derived therefrom. 



Witness my hand this day of 191__. 



Approved at this day of 191__. 



, Secretary. 



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