American National Contracting

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DURING TI{EPASTd VEAA8 ANDAPPROVED TOFEPFESENT LIEf ALLCOMPANIES VOUHAVEBEENLICENSED Nsme OompanY (u{guroEFuFlFvgonAlrelFHoirE)

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. If bolng appolnbd nm{esldcnt In Ftodda, @so provldealt counthE Boldthg b08lnsrs,

. Haveyouswr repras€nl€d AmorbarNalonalor snyot ttssubsldhrl€r?o y6€ tr No ll .yeo,,provldsdEtalh ihroughanolhornamsor agencyln thBpa€tllveyaars? cl Ye! o No lf ryes,'iprovldedetqllt ' HrvEyousoldInsuranc€ ' Th€ Vbl€nl orlms & Contol Aol ot 1s9'l makoglt a crlmlnalottonrBtot ahylcnewho has be6o oonvbtodol any gdrnlnsllelony Involvlng dbhon€Elyor a brBaohol trust to wlllfullysngags h iho buBlnersol lnsurams.

Hayeyou€v6tbosnlMlctodor convlcled ot anysuchtebny? OYos ENo Havoyoobegnansd€dtq anyothsrcrlmg? E Yss oNo It yeo,pl€areglvgspgollios as to ohargs,dgle,ludsdblonandoutoongi . Havt you dt/el.tled or bsq| dslardd bqnkrupt? E yss tr No . Aro you qlnsolly obllgatsdundff a norFoompotssgro€(nont vrllh any lnglranoo oqnsny o. sgsnq? E yos E No . Aro you prB8fily hdebtodto any InsurancocompAnyor agonoy? nvog o No It y€s,r proddo dgtolts ToWhom

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Policyt EltsollvoDat6 Erylradon Oala go Hsvgyouwar nbd an enorsand 86lo,tsclalm? Ey.s ONo Havoyoue{6| bsendleoldlned bya stateInBuranoe dearlnor ? f,yos ElNo Havgygu€verbesnoaudonod or dlsolplhod fof vlglE0ng s protesslonal codool ethtc6h ary organizaon? try6r trNo Havoyqr ovorbeanoxpgtledor dlrclplhsdby a prcl66stmal organEallon suolrss the NA!U? try.. ONo a bushossrslatlgnshlp ' Aroyouswargol anyolhetInlomatlonthetAmorlcrnNsttonalshquldhavoIn aEe€rslng wlthyou and/o(yotr oornpany? tt Yo! E No lf .yee,,,ploa€sattaqha detauodgtaloment' . . . .

poEonslgnhgthlotormsB'Appllcanl".horeby T1|€. ad$owledgosthat.lhoya(o not obt8lnln0I thsnse/eppolntmont wlthAnrdoan Nallohal lmtranc€conpanylo. th€role FrrpoEe o.lntenttoo oniie applloanl.a idnclpally6 soibnotphc€ tnsurence ownlltoor thatol relatfue8, snployst'r ot employ€BB, liEvs reoolvsd. Jsg4undoEtand andagroglooomplywlthlhecontents ol theProducs/scodeof Conduct,thsAdvot €ktgOuldglhes, lhoNoll@ot P.lvaoyPottoyandthecompanycutd6b Anrt-MmeyLsundertng adopiddby Am*cE; Gr6;i ilA;iirtft;;". Flrthormoro'sadl ol thounderolgngd dgclar8s,orrum5€ll/h€Ir€ll, par oE,fut allo, thoanBwers ard .ll oth€rlht€r€etod ln tfiooaooe ot Inlsappllmllonano.anyoupplemos lo It arotull,complolosndtrusto th9 bert of hlsltg| kno{rledge andbelgl. In addl gh,-tl|€ undortlgned spdolnoally allolt8 IhatlhosoolalBoourlty-Ndmb€r or Taxtdentltbaon Nurnber on ttreappltcatton ti iiri J6;il ilr;br. for lhoonlllyapplylng lor appolnlmont wlthAn8rlcrnNs0onat Insurance Compe;y. l, thsAppllcani,hsvorsa4oI thr datorho$,nbelow,acopyof thoabovostatsnEnlsrs requfedbybw. I haw aleo|Egd,qndoretoo4 arrdrlgnodEoolv or AuthorE!flooFofms470D, r undorr6id rh.arhstsntngrhtriormanoioiir ttrfr, I iil;;i;ii;;t; ril;;jil; atanyttmo,to Invoedgat!my backgtound, Includlng mycrgdlthlBt;ry.t!9l,q!t tomako€w llonrcquestlo cornpsny's Homooltlao porlodol rtmgforaddltlonat, wlthha r6q6onablo dota€d $qgll!"" |lro|nE|rlon concarntng thonatut€andscopsot lhoInv€8llgEllon.

Dab Forn 8770

Appllcanl A6v. 0d/08

company AmorlcanNaflonalInsurancE Company Gulde to Antlllllonoy Launderlng As an h8uranosproduc€r,your gkillsaod servloe6h€lpoul End86c{flly. Slnceyou ar€ dlBntsachlgvsfinanclalEuocgss on th6 fmnl lln6sof a rxJltl.bllllondoBarlndu8lry,youafa In a unlqueposltlonnoi ont lo Esrv€our cllsds, but abo lo ssrv€ lhb ooonlryby h€ldng prerEntmon8ylaundEdngand the ffrEnchgof iarmdsldlYlu€t. To oompUwllh ne$,{od6ralanlfmqtByhundo ng rogldatlon8 fur In8urancecornpanles,our fsmlly of compsnles lg lmplsm€nllng a dstallodantl-monoylaunderlngpmgmm.You havoan lmporlantroh lo plsy lo lhatprogrsm,Youmayo{t6n bo In a crltlcalposlllonlo obtalnInformallonrogardlngtrg oustomor,lhe ouslorneissourcaof furds iot lhe produdsw€ E€ll,and $s didome/s ro$on8 for purcharlngan hsularEo fiodud That h r6[hg lndMdjal anrull86 and llto In8uranc€,lh€ progrsmroqulr€syoumust Compgnylsnu.money laundorlng . En8urothet all Informatlonrequestedon tho produol docuronts 18accuratoand spdlcadonand asBodated @mpbl6.ftdudng tha UgA PATRIOTAc| N. ficBtlon Vetmcadon tormfor dl noildGntlflcslbn 8ndC-rr6{om€r vadabhhrEin9sg. contact the 8pproprlrb Aod{rloncy Launderlng ' (AML) compllmo omoor It a cu8tomer laallta ptrvldlng Informagon. (Soo conlsct Informallon turlhd ln lhlEdocum6nt,) - R€clrds of Ihl8lnlonnalonmuslbs tstElnedag longas S|oconlraotromattEIn forcaatd for fl\,B y6arslheroaftar. . Nodf he approprlstsAML rpmpllanoeoffc€r lf you del€ct eny monsy launderingIed flags, ro lrrEl 0|g comp€nygan dslsrmhE,nhethera suspldousacllvlly of reporl(SAR)mustbe tlbd wllhlho U. S. Dopartmonl theTr€ssuryor Enyaggnoylhereol PooEfbloR€d FlagA6{tulty(fof a @nprel!€nalvend ot td Natlo,?8,l) naga*W c'/ntsd,theMlL otfrnr dl Anl6.Iicf'n I Th€ puroha8eot 8 product lhat eppears to bo neads wltha cuElome|,E lnc'onslslenl . The pr.nohass oafundlngof a produotlhat appEarE lo 6xc€sds custofie/8knownIncomeor llquldnotworttt . Any atlsnpteduusud fllelhodof paymont,pai|c|isrly 8llchas mol€y otd€.sgr by oqrh or cssh gqulvalenls, carhlercfiockg . Psymsntot a lEtgeamounlbrokenhlo sev€r€lEmsllg amounla . Lltll€or m conc€mby E c[Slomertor th6 performance of an hsurancoploduol.btd muohconoEmaboutlho Earlytamlnalloofeaureaoflie prodld . Tha rduclams by I dr8lomsrlo provldotsondryhg Infomallon,or lhs ovlelon0f hfomatlofl lhat 866ms flctltlous . Anyolhoracdvltywtldr youlhhk l8 susplolous

ANICOAlt{LContaetInformatlon RaportSuephlou. AclN y To YourAML catplaDo, ofllcer- You AML ComD[encr ofrbet l$ thell rer{f,nsl e lot nolllylngN,t'i'O'' l/./t utg. lt you do not haw an AlnL cor'rydf/rfieOlfr4r,till lEWw nry,msfbry lo twort sufddol/€adw to Nll@'s tlol'J|€. Con acr Judlth L Reglnl (Judy), AsslEtantVlcB Plg8ldsnt, corpor8te compllano€, Chlef Lrwderlng oflhEl totAnll.Money Compllanca AnalFtI Of Erln Elllott, QualllyAssuianco P.o.Bo( 1800,Gd!6slon,T6xrs7756389m Msll: Prorrej (800)93&5975 (40S)€21-3886 Fax: Emarr; [email protected] Typ6oof Psymenb Aoaoptad Adei.s ciJsloiriorslhat only lh€ blowhg lypBs ot psymentmaybgaccBpted: . PsrsonEl6eoksandpB-authodzDd cheokpEymonts. I cash (curencyor coln)In amools le88lh{t $1,0m, . eEsh equlval6nb(monoyord6n, calhler's cheoki, Irsvelelsoheqke,baokdrsltB), b€ .€podsdto - CaBhandaashgoulv€lgtt6fru.r6t tho lRg and FInCENon Form Bg)0 t{h6n paymonbreoehedby the comparryIn 8 ehgle transsrdon or ln tlvo or nors rohtgd lolsl mola th|n Si0,000. Relatod tr€nB€ctlone transaollonsoccurdng vrlhln any l2-mon[l perlod would be eggregetsd for tepoftlng purpo66scvonlt Indlvidually lhoytrst€ l€€8than $10,000.lAgenle mey have Indepsndonl I€ponhg oblgslktno and should ohsck flelr cottp$!"! wobCt6for add[orC InforndlonJ . It a cuafjomo?ptovldes a tonn of payme,rtahaatE nol pan,'/fl.4 do mt accaPathe prytnont and now tha .ppro,,|,!te AML aot',y'hnco ofilcer f It gt0alerthan 81,0N, k In an ',l''ounl Note An en/@ya4 sg&ntor brokar mutt not, und8/" any cl.c{tmsttncoq &sctoss al|ft In h# tworaed tutptclow ac,lvLyor rattWs b aheConpany. tals ahe aotg respottglbry of ths Coflrptoy's AttL ofilcar b ds|d|'],lina wl'',lhal a SAR 18 fllod Mth th€ Depa'of Tho AIqL olrlc.r and the Company 8rc tquury. orohtblbd from dtsclo'lrrg to tho aganl and any olher 'parcon thata SARhat bem f,ld. Tio Compqny8nd [s p.oducors sharq En lmpodaot programenda[ rosponsbdllyIo conplyt{,lh [|€ Compeny'8 Entl{rDngyhund€rlnglaw!. A lallurgto do 8o $rlll appllcEblg con8tlluteground8 for dlsobllno, up to and Indudlng tsrmlnallon.In addlllon,vlolsllottof anll-nronoylauderlng lav{smayexposolhos€rssponglblg lo 6ubstsntlalpsnel!68 undEr f6d6rel l6nir.

For Mo]o dotatls on osch of t,laae lequlromontr, oontacl tho AML Offlaor ot Amorlcon Nsalonal.

Form4475

0E/08

AUTHORIZATION RBquhedby Th6 FalrCrodltRepodlngAct

Tho FsdgralFalrCredltReporthgAcl, as amondodrprovldedthal any consumer rsportlngagenoymayfumlaha comumarreportIn accordancswl$ he ffltten lnstrudlon8of th€ consumarto whomlt r€latea. .In aooordsnc€ wlh that provlslon,the personEignlngthl6form aB ?ppllcsnt"h€Eby suthorlzs any pereonor agsnqyto gfue, In wrloog, orally, or h any other fum, lo AmarloanNatlonalInsuranaeCompanyor lts deElgnated rspreBentatlves any Intormsllon gatheredot malntalnedby s consumorraporfng agoncy bearlngon ths Appllcant's credllworthlness,cr€dltBtardlng,oredltcapscity,chalact€r,gsnoralroputaffon,pgrsonal fiaracierlstlcs,or node of llvlngwhlch ls u8edor erescted lo bs usod or oollsded In whols or In part for tho purposeof seNlng as a tactor in astsbllshlngthe Appllcanlh e glbilltyfor oredlt,dnp,oymantor any otherpurposgauthodzedunder Ssc{lon004 of f|a Act. ufderstands Fudher,th6,qppllcanl thatAmerlcan Comp€ny NatonalInsuranca mEy,as part of lte normalproceduro,requ€stthat an lnve8tlga$vgoonsumercledit raportb6 mado wherobyInfofinatlonon tha Appllcanf6charai6r, generalrepuldon, personaldlsrsclerlstlcsor mode of flvlng 16obtainodthrcughpersonalInl6rvblr,gwllh employorB,frl6nds,nolghborsand otherswlth M)om tha appllcant buslnes8as8oolates, may be aoqualnlodor who may have knowladgsclncBming any such ltems of Infomatlon. Th€ Appllcant authorlz6 the lndlyldual or agcncy aonducdngths Invostlgatlon b glva,In wr ng, orsly, or any olhcr form,to AmerlcanNa0onalInaurance Companyor lts doslgnatedl€pre8sntatlvseany Intormallongathdod or obtalneddurlng thls Invo8tlgaton p€rtalnlng lo Appllcanfs prcductlon, perslslsnGy,commlsslons, eafidrEs,ostfnabd fuhre eamlngs,commlslon advancesloans,and d8bb, hcfudlng, but not llmltedto, any indcbbdnossthat may have been chargodto th€ Appllcanfs manageror agenoy,or whlchmayhavebeonwdtlenoff. Ihe Apdlcant authorlzesAmerlcenNatlonal InsuranceCompanyor ib cl€slgnatBd raprsEentatlve€ to u6eihe r€portsfurnl8hd ln aooordanoo wfth fils authorlzstlonIn any dsllb€rallonswhlch lt or hey may undedaketo determlnewhetharof not Amorlcan NatlonalInsuranceCompanyMll mak6an off6rof a contraolb the AppllcsnL

(AppllcarfoSbnaturE)

(App[cant'8PrlntodlGm€)

(Ds)

Form4708

(SooblsooudryNu6r)

Inflmffimffxl

R€v.11.00

AMERICAN NATIONALINSURANCECOMPANY Why Dlrect Deposlt? DllsotDspoEltls therecommend€d methodotpaymeniotcomml3slons to compensata outproduoors.Ther€arsa numberof paldby DlrootDeposlt. benefltsto havlngyouroommbslons '

SECUR/ry- Tranaiorls done elsctronically- no extrs tdp to th€ bank to EtsndIn llnE

'CaNVENIENr-V{'i.ywaltforlhomall?Nomorelostohe6l(8,delays,eta.Youroommlsslonswlllb€d€poolledevsnthough you may be oul of th€ offlce or out of lown. '

GUARANTEED-In youtacoountby Fridayottho pay$€ek.

'

HOWMUCHPAIDFORfHE WEEK-Cd| 1.800-8904504 for yourcommlsslon amounl24hoursa day(canstartcalllng afler 12:00P,M.on Tuasdayofthe paywsek)

lfyou ohangsbankswhlls onDlrectDopoElt,ws oncouragoyouto oontloustc malntalnyouro(lotlr|gaccountuntihvocsn ahango bac* accounlsln oul syst€ms,ThlBwlll ellmlnatgthEn€edfor speclalchocksanddolayBInrocelvlngyoundul€ dlrestdepo8ltB. PlEassnotethat lf yor choosenotlo ussDh6ctDspolli as yourm€thodofpaymert, thatlho ploc€dur€for repbclng lo6tchecl(8 ls a l€nglhyproce$, A"stopprymenf hastob€appllodrrd conflrinedbeforsthEbst orexlstlngcheckcanbe r6lE6u€d. Thls procasstEkosappfoximrtaly2 w6Eks. pmoessth6lwlllmakoit ea8lerforyouto acc$8 Inbffiatbn r€g€ldino DlreotDspo8ltls ongolthest€psInANlcO'sautomatlon your psymentot aomml8slons. AUTHORIZATION AGREETSENT DEPOSII FORAUTOMATIC lauthorL,aAmarlcanNationalInGurancs company(ANICO)andth6 bant llstedto depoanmycommlsslon8 io lho account namebelow.Thisauthorltywlll remalnIn effoctuntlllhavs s n6wauthorlzatlon orcanc€llellon.ThecompanyroasrvsSthc rlght to Inltlated6blt entrlss for r€ooveryof sumEdueto of€dltedrles processgdIn anor, lf dqtormln€dwlthin the u/€ekofihg crodltentry, A Volded Check mu3t bo submltted wlth your requegt for Dlroct Deposit. AOENT

ssN#

AGENCY#

(MNK) NAME DEPOSITORY

ADDRESS

CITY,STATE,ZIP

CHECKINgACCOUNT#-9 DIoITROUTINO

SAVINGSACCOUNT# 9 DIOITROuTINO

cREDtTUNION__ ACCT,-%TOCHECKTNG

% TO SAVINCACCT.

MONEYMARKETACCT

(Nameas lt Eppearson checking6ccounl)

(N€m€as ll app€Erson EavlngsEccount)

lf contractfllalr submlttod eloahonlcally throughnomofeforms, avoldgdcheakshouldb€scannod andsu!'rnlttgd asqn plo66€ allachmenttothotll6oryoumayfaxI copylo 409-62'l Itsubmltul|g volded ch€ck fog by hdudo col/orBh€€e a -3032. thtoughnomoroform3 Indloatlng orlglnalfllewas€ubmltled ndms, andllstappllaant's EFTPROCEDURES OncoyouhaveBlgned up,yourcheckwlllbeautomatlcelly dopoellcd Intoyourchee*lng and/orsavlng8 scoounl g..lw66kofromthedgythoHomoOlflorrocslvod g approxlmatoly thoFquost.Youwillrec€lvga'DEPOSITADVIC yourcheckslub.Thlstormwlllshow yourgroEs bm whlchwlllroplaao andnoipayforthemonlhandyear-to-data. It rA,lll al8oBhowolhefdeductlons, FotAganlUeeOnly Form4689

Rev.02/06

AMERICAN NATTONAL INSURANCE COMPANY GALVESTON,IEXAS CDNERAL AGENT'S AGREEMENT AmahanNationalhrsunurco (hereinafier Conrpany dosigrrated ur "Courpoly")hcrebyappoluts its GENERALAGENT(',GA,'or ayou') wltbt[6 a0thorityardobllgstioNset fotthin thisA{reemart!alldyou8cc?t yourappolfircntsubjcat to tfioterru andconditionr ofthlsAgraanartandall IrlatcdSalredulca ard gupplcmcnts rclatedto iL Effec-tlvc Dat". ThisAgrecment rhallbecorreelfcctivcm of lfany provisiou thcAgrlernentis row or shallin thef.rhurbcin connictwi66![pt6UiiIiE6fiEifr:arrneiriof hsuancs rulingor order'it sballbomdiffed b thecxhntn€cosssry for corDpliffoe.Itis furceuredshaflsuperaede altpreviour aBlomerltsbetwoc(l thopsfti68. OEliEIl,{L AOENT;

Agroffiarocoffensrfioosohedur€) dBlldtcirE

By: (gignaturo)

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(Sigrstur! of Organizadotr ReprEsettadve)

Submlttodbv:

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AMERICANNATIONALINSI,JRANCB COMPANY: Rccruiter'sP€ruoullCode#:

BBNEFICIARY TORECEiVE@MMISSIC*\TS PAYABLBAFTERDEAII (LIMITED10 ONE INDMDUAL):

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By Tldo: Executivo VicePresident IndcprndaltMarkdingCrcup

(PristorTypo) NameofBeneficiery

Dqte:

A[thorlty - You arc herlby ruthodacd to dovclop lnd Bupowirotho lonpltry'r brsbclr i$ confoMity with tbc rulcc rod rcguhdor8 of tl6 Corrprny. You shall rlcnrli ard rccolisrcud for rppoidE6Dt by tho ConlDa[yindivldualr aod sgodci6.q$lilicd lnd expcrienc.dIn llft Innmtrc6 inls .nd .orvicc f,s 0g fr. You r|)|lll tllln snd $peivls6 sr.h lgcrls in accordlno! l'lth dlo rlr&l6rd! of rio corrpory ntld th6 Isqulr€nEnt! of lh. rtslc o. ststesh whlch llEy ftDctiotr fol tbo corlrpllry. You 0ckno1{ledBgtlldt sll .8erh iI youl hisrlrchy lrt indepetrdo contrsolon oflho oompsnyrtrd, dt I subs8ed'r elcstionor !t thc solr discrdlor!ofdro Cofiprny oan b9 lraryfcned by |6 Conps[y h acoorddro wldr tho CoDrpo$y'stn$fer rules.

You rlrdl !t sll timec coDply wlth tho ruler nnd rog$htion! of the CooDdy pcrtrinhg !o urdcrirritihg prar*ioes, monphnooofrirkr, dclivgry ofpolicics, md all oth6r0F6! of ooDdlct of tho Co$p!ny'! b{siocsr. ftg 'tbtiotrlhhis betwB€o t! Corlprny lnd yo! plrotsd by d r Agltdrcrt thit of sn Indcpordg|rt oontlroto!, rnd rothlng In ttls AgllcDort rlsll b! corstrucd s. oertlng rbo rll.tim.l||p of 6,q)loJ6r 0nd anploy.c botwoc0 thc Con{t.ny and you. Neltlrer yor [or. your orDployosrnor ag€nrsshsll b! deoD€d to bo tho smployosor 0eivrnt of$o cotrprty. You sh6ll '!ot bo. full-tlu6 hmtmnocdgcntri dcfincd lty tho PodcralSoridl Scq|flly Lrw' Noo! of6g brnsfltr pmvld6d by tho Cornp8rly to it6 euplo]&cs, iDcludln& bnt not llDritod to, wo*d,s coffpemstiollitlrur!||cs s[d urtomploymont in|um||co sro rvsihblo io you, your crllloyo€r or qgq r. If tr0idry couner, rrlae [rtlodr ind urtari8l or slnllar aids rtrd Nervlco!sro oxlend.d or lrladorvaihblc to yo\ lt b r$red tist thcir purporc rnd rffcct dtqll mt bc b givo th! Comp.ly contml oltr your tltno or dltlction, but only to o$i6t you in yoilrbu6lncss.

You rhsll sollclt aprllcatlottr for odllury llfo Ir mnoosld a![uitlos to be lssocd by tll6 Cornprny rod submit ruclr rlpllcationr rcc6lyqdto dro CoNpsly, provlded thnt yo$ 0r! plopo{y lhcdici .r rcqui€d by rly tovcmmcrfil lul[ority rppllo|blo to yon, You shsll dcllvff Dollaler lssu€dbI dro compuy, oolloct tfio lirlt lrstuluN the]ofor, trflu|lllt all collcolloE hnncdlltcly to tho C,onpeny, ond rruto cvoty offort to orhlah h forcs all pollcier lssuedby tlle Co[palty, Ford4737

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