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Declaration
By submitting this form I declare that the answers to the questions and statements above, whether in my own handwriting or not, are true and complete. I understand that the answers to the questions and statements above and any documents required by KOLAL shall be the basis of the contract. I accept that KOLAL will incur no liability under this application until: the application has been received and approved, the full modal premium has been paid to and accepted by KOLAL. l understand that KOLAL has the right to defer a claim under this policy until all requirements, as specified by KOLAL, have been met. I acknowledge that I have read and understood these declarations. I declare that the answers to ALL the above questions and statements are true and complete.