[...]
In connection with Policy No
issued by your Company, I hereby request that each annuity payment as it falls due, commencing with the payment due on or after the first day of the second month following Atomic Energy of Canada’s receipt of this form be paid to the Receiver General for Canada (to be deposited in the Superannuation Account) and agree that such payment will constitute on your part a sufficient discharge of your obligations to me with respect to annuity payments under Policy No
.
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