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Integon National Insurance Company <br /> FRAUD WARNING —CALIFORNIA <br /> For your protection California law requires the following to appear on this form: <br /> Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a <br /> claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. <br /> 13290(10012021) <br />