Section 753

Section 753.EXHIBIT A Authorization to Accept Filings by Reference (Form RF-1)

Date

AUTHORIZATION TO ACCEPT FILINGS BY REFERENCE

To the Director of Insurance

State of Illinois

Advisory Organization	Line of Insurance	Manual Rules	Policies and Endorsements

	Private Passenger Automobile	[]	[]

	Commercial Automobile		[]

	General Liability		[]

	Buglary and Theft		[]

	Glass		[]

	Boiler and Machinery		[]

	Workmen's Compensation	[]	[]

	Dwelling Fire and Allied Lines	[]	[]

	Commercial Fire and Allied Lines		[]

	Inland Marine		[]

	Homeowners	[]	[]

	Farmowners		[]

	Commercial Multiple Line		[]

	Crop-Hail		[]

The undersigned company hereby requests that it shall be deemed to have independently submitted as its own filing the manual rules and/or forms filed by the advisory organizations indicated above, and as a change in its own filing any future change in the manual rules and/or forms filed by said advisory organizations and accepted for use in this State, such change to become effective for this company upon the same date as it becomes effective for advisory organization members and subscribers, unless otherwise stipulated by the company.

This request and direction shall become effective as of the date or dates listed below, and shall remain in force until rescinded by either party.

Effective Date of Authorization
Exceptions (if any):

Company	Official	Title