Cal. Code Regs. tit. 10 § 2249.10

Current through Register 2024 Notice Reg. No. 50, December 13, 2024

Section 2249.10 - Schedule Blocks

	MH1
Insurers Name and Complete Address Called We or Us
SCHEDULE
	SC1	Primary Borrower, called you, and Address
	SC2	Co-Borrower, also called you
	SC3	Policy Number
	SC4	Source Code
	SC5	Creditor Beneficiary and Insurance Agent's License No.
	SC6	Class of Business
	SC7	Secondary Beneficiary
	SC8	Term of Insurance
	SC9	Effective Date
	SC10	Original Amount of Life Insurance
	SC11	Scheduled Expiration Date
	SC12	Monthly Loan Payment
	SC13	Monthly Total Disability Benefit
	SC14	Decreasing Life: Single () joint () Premium:
	SC15	Disability: 30-day Elimination Period Premium:
	SC16	Total Premium:SC17 Maximum Monthly Disability Benefit:
	SC18	Maximum Amount of Life Insurance:
	SC19	Decreasing Single Life Premium:
	SC20	Number of Monthly Installments
	SC21	First Installment Due Date
	SC22	Final Installment Due Date
	SC23	Amount of Level Life Insurance:
	SC24	Level Life: Single () joint () Premium:
	SC25	Level Life Single Premium;
	SC26	Group Policy Number
	SC27	Certificate Number
	SC28	Date of Issue of this Certificate
	SC29	Credit Insurance Applied for: ___ Single Life___Joint Life ___30 Day Elimination Disability
	SC30	Monthly Premium per $100 of insured debt: Single Life $___ Joint Life $___ Disability $___
	SC31	Credit Insurance Applied for:___Single Life ___Joint Life
	SC32	Monthly Premium per $100 of insured debt: Single Life $___Joint Life $___
	SC33	Credit Insurance Applied for:___Single Life___30 Day Elimination Disability
	SC34	Monthly Premium per $100 of insured debt: Single Life $___Disability $___
	SC35	Monthly Life Insurance Premium per $100 of insured debt: $___
	SC36	Monthly Disability Premium per $100 of insured debt $___
	SC37	Maximum Disability Benefit Period
	SC 38	Disability, 30-day Elimination Period: Single () Joint () Premium:
	SC 39	Credit Insurance Applied for: Life: Single () Joint (); 30 Day Elimination Disability: Single () Joint ()
	SC 40	Monthly Premium per $100 of insured debt: Life: Single $___, Joint $___ ; Disability: Single $___, Joint $___

Cal. Code Regs. Tit. 10, § 2249.10

1. Amendment filed 7-25-83; effective thirtieth day thereafter (Register 83, No. 31).
2. Amendment of section and NOTE filed 10-2-2006; operative 11-1-2006 (Register 2006, No. 40).

Note: Authority cited: Sections 779.21 and 779.27, Insurance Code. Reference: Sections 779.4, 779.6 and 1758.99, Insurance Code.

1. Amendment filed 7-25-83; effective thirtieth day thereafter (Register 83, No. 31).
2. Amendment of section and Note filed 10-2-2006; operative 11-1-2006 (Register 2006, No. 40).