MI ALTA U.S. Policy Schedule A

SCHEDULE A

File No.:

Policy No:

Amount of Insurance $

Premium $

Date of Policy:

1. Name of Insured:


2.. The estate or interest in the land which is covered by this Policy is:

3.. Tttle to the estate or interest in the land is vested in:

4.. The land referred to in this Policy is described as follows:

STEWART TITLE GUARANTY COMPANY

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