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Name and Residence of the Party proposing the Assurance ...
Amount and Term of Assurance
Name and Rank, or Profession of the Person whose Life is to be assured
Place, and Date of Birth
Present Residence
If employed in any Military, Naval, or Preventive Service
If had the Small Pox, or undergone Vaccination, and which ...

If by Birth or otherwise predisposed to any Malady tending to shorten Life,—to what •
z If formerly afflicted by any Malady or Maladies tending to shorten Life--the Period of the

Occurrence of each—its Duration, and permanent Effects on the Constitution
If at present afflicted with any such Malady-the Time of its Commencement-and its sub-

sequent Progress ....
The Names of all the Medical Persons consulted on the first Attack, and since
If intending to go beyond the limits of Europe-to what Country, if the residence be fixed

to what Countries if the liberty of journeying be contemplated—with what Purpose

and for what Object ... Reference to two Persons of good repute (one of the Medical Profession) to ascertain the

present and ordinary State of Health of the Person whose Life is to be Assured . $

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No. IX.

Form of Deed for establishing a Life Insurance


In preparing a Deed for establishing a Life Assurance Company two points should be particularly attended to.

1st. To limit the responsibility of the Shareholders to the amount of their respective subscriptions.

2nd. To give to the public à right of suit against certain individuals, and a remedy against the funds of the Institution for the amount of their claims.

The first is only to be accomplished by the Company's having no transaction except through the medium of a written contract, in which there shall be an express declaration that the party contracted with is to look to the Trustees alone for the payment of his demand, and to them to the extent only of the Funds of the Company.

The second point is to be effected by placing the Funds in the names, and in the legal and actual custody of three or more Trustees, every one of whom shall sign every contractthereby declaring the contract to be a charge against the Funds themselves, and against the Trustees to the extent of the Funds. By these means the Trustees will be the only persons to be sued, and will be clothed with the Funds to satisfy the demands against them. By this arrangement also the Trustees would be the only necessary parties to prosecute a wrong-doer.

Indenture Between all the Shareholders, except three, of

the one part, and the three excepted Shareholders, of the

other part,

Recites the agreement for the formation of the Company, its

objects, name, &c. subscription for and delivery of Shares, &c. &c.

All the Shareholders, except the three, covenant with the three

Shareholders, and the three excepted Shareholders, covenant

with two other Shareholders as follows: That a Company called the Company, with a Capital of £

shall be established.

That its objects and business shall be

shall be the first Officers of the Company. That it shall be regulated as follows:

AS TO GENERAL COURTS. That the Shareholders are to meet once a year, and when

duly convened at the office. Such meeting to be styled a General Court. Ten or more Shareholders holding

Shares, a quorum. Annual General Court to be held in the month of Extraordinary General Court to be called as follows: Three Directors or Ten Shareholders may require the Board

of Directors to call an Extraordinary General Court at

any time.

Three Directors or Ten or more Shareholders, holding at least

Shares, may require the Board of Directors to call an Extraordinary General Court for removing Officers for certain causes.

The requisition to be left at the office at least thirty days,

before the Court required, A copy of requisition to be left with the Officer to be removed,

at least twenty-one days before the Court required, If the Board of Directors neglect the requisition--the per->

sons requiring the Court may call it by advertisement. General Courts may adjourn. The business at Extraordinary and adjourned Courts, to be

special. Chairman of General Courts to be the Chairman, or

Deputy Chairman of the Board of Directors, or a Director,

or a Shareholder, to be chosen at the meeting. Minutes of the General Court to be kept and signed by

the Chairman. Three Shareholders may, by writing, demand a ballot to be

then fixed by the Chairman, at a distance of time between

twenty and thirty days, and to be open from 12 to 2 o'clock. Qualification for voting, is Shares and months standing, Shares-one vote,

Shares-two votes,
Shares—three votes.

Shares the maximum of
Shares allowed to any one person.
Three-fourths of the votes of the Shareholders present at the

Quinquennial General Courts, necessary to declare a divi

dend of profits among Shareholders. Three-fourths of the votes of the Shareholders, at two

Extraordinary General Courts necessary to alter laws,

or to dissolve the Company, In general a bare majority of votes to be sufficient. Chairman to have the casting vote. An Extraordinary General Court to be called to elect three

first Auditors.

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