Report (119) Signature Certificate RightSignature
Document Reference: F8DISBJJ5KN9TGHKYIXGL7 Easy Online Document Signing
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jcclin7gmail.com
Party ID: NMJUGPJMJ2ETZKR8PLPE8C 14 **'17C
IP Address: 39.9.126.14
I [-VERIFIED EMAIL. Jedin7@gmail.corn
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- - I Pat Killeen
Party ID: RARYMBIIYJHYNJ5TBTFLEY ?sh-\(4,11\--
IP Address: 50.252.8.105
I VERIFIED EMAJ pat@equitygroupinsurance.com
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Diroital Fingerprint Checksum 69eb792°66edo4bbbb5a7430d816;abba5efa5oc
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Timestamp Audit
2018-07-27 15 29:23-0700 All parties have signed document.Signed copies sent to:jcclin7gmail.com and
Pat Killeen.
2018 01 2/ 15.29.23-0(00 Document signed by jcclin7gmail.com(jcclin7gmail.com)with drawn signature.
-39.9.126.14
2018-07-27 14:20:09-0700 Document viewed by jcclin7gmail.com(jcclin7@gmail.com).-39.9.126.14
2018-07-27 09:08:17-0700 Document signed by Pat Killeen(pat@equitygroupinsurance.com)with drawn
signature.-50.252.8.105
2018-07-27 09:07:50-0700 Document viewed by Pat Killeen(pat@equitygroupinsurance.com).-50.252.8.105
2018-07-27 09:07:50-0700 Document created by Pat Killeen(pat@equitygroupinsurance.com).-
50.252.8.105
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41-.1c"K This signature page provides a record of the online
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