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AMMOk <br /> 6. Doter information (continued) <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 <br /> make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state <br /> prison, <br /> PL-50014(11-20) Page 4 of 4 <br /> 0101OM2093 <br />