32 BULLETIN 530, U.S. DEPARTMENT OF AGRICULTURE. 
Form for outside of policy: 
NOs ee 
POLICY 
Farmers’ MuTruau 
Firs Insurance Company 
(6) eee ea te te Mea 
EES OSes ee eas So IE LD SOY NCEE a Mh ae 2 
OPS sn RO et ane ee a SR aaa aes 
Policy fee, Pesce 
Initial premiuin, 2 RRS 
RO GAL yc tpl te ene Reena 
| 0s x: (> ileal rn none ana My el poe Se ke Se ee TO 
Application taken by 
Amount of insurance, S 
