Application For Life Insurance, The Lexington Fire, Life & Marine Insurance Company, in the State Of Kentucky.
7 1/2 x 10, two sided imprinted form, that has not been filled out. There is a series of questions such as when and where you were born; where do you now reside; are you in good health, have you ever been afflicted with Gout, Consumption, Scrofula, Convulsions, or Palsy; are you in the habit of drinking spirits; have you been vaccinated or had Small Pox; and more. The reverse of the document has places to be signed and documented as to the information given, etc. Dated in the 1830's. Light wear. Very fine, and interesting, unused early 19th century insurance document. |