1. (a) For the purposes of RSA 260:14, V(a)(10), a written authorization shall be submitted on letterhead.

2. (b) The request shall contain the following:

   1. (1) Date of execution;
   2. (2) Name of life insurance company authorized to write life insurance policies in the state of New Hampshire, or its authorized agent;

   3. (3) The following information about the individual whose record is being sought:

      1. a. Name;
      2. b. Address;
      3. c. Date of birth;
      4. d. Driver license number; and
      5. e. Signature of the individual whose record is being sought.
3. (c) Approved written authorization shall be retained by the life insurance company, or its authorized agent, for a period not less than 5 years.
4. (d) A life insurance company, or its authorized agent, shall produce approved written authorization upon request by the department, or its authorized agent.

Source. #7621, EXEMPT, eff 1-1-02; ss by #13152, EXEMPT, eff 12-31-20