Bureau of War Risk Insurance Provisional Receipt for George Rehn - October 9, 1919

Transcript

K69347 All Checks, Drafts, and Orders Must be Made Payable to the Treasurer of the United States 32 TREASURY DEPARTMENT C 1280 BUREAU OF WAR RISK INSURANCE Provisional Receipt -- United States Government Life Insurance Receipt is hereby acknowledged of the sum of Twenty & 10/100 DOLLARS ($20.10) in Check No. on the Liberty Bank of St. Louis, St. Louis, [Missouri]. On account of the first Quarterly Premium on $2000 of United States Government Life Insurance on the 20 Yr. End. Plan applied for under date of [September] 19 1919 (Month) (Day) by George Herman Rehn at age nearest birthday of 31 Years and whose Home address is 4704 Hanover Ave., St. Louis [Missouri] It is understood that the receipt of this payment by the Bureau of War Risk Insurance does not operate to grant insurance and it is further understood that the United States Government Life Insurance applied for does not take effect until the application therefor has been approved by the Bureau of War Risk Insurance. Dated at Washington, D.C. the 9th day of October 1919. Bureau of War Risk Insurance, Treasury Department. By [blank]. Ins. Div. Form #263 [stamp] REC