Insurance Contract for Catherine Queen, 1910 December 1
Insurance contract filled out in black ink for Catherine Queen. The form is entitled "Request for Amendment of Ordinary Policy Contract" and informs that Catherine Queen's insurance policy will change so that the policy is payable in case of death to the Jewish Consumptives' Relief society in Colorado. Form is signed by Catherine Queen in Edgewater, Colorado on December 1st, 1910. There are two witness signatures, the first illegible and the second "N.P. Levin."
- 1910 December 1
- Prudential Insurance Company of America (Producer, Organization)
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1 Items (contract)
Scope and Contents
From the Series: This series of patient records includes medical reports and histories, statistical data of patients, x-rays, and death certificates. The patient files include applications, correspondence and some may also contain photographs and personal items.
Physical Characteristics and Technical Requirements
At the bottom of the contract is a purple ink stamp that reads "Policy Dept. A.H.L. Dec 9 1910, referred to..., awarded...". Underneath the stamp is a handwritten note in pencil that reads "1234." On the back of the letter are three stamps, one in blue, one in purple, and one in black ink that are identical. They read "Ord'y policy dept, J.V.R., Dec 9 1910, change section."
Title supplied by archivist.