Type of Coverage Requested

1. Will the animal be observed and cared for daily?

2. Has animal listed received treatment for an accident, injury, sickness, disease, lameness, displaced abomasum or bloat in the last 12 months?

3. Other than for routine care, is the animal listed receiving regular treatment, medication, or supplements?

4. Will animal be transported during coverage period?

5. Is the animal due to calve anytime during the requested policy period?

6. Has the animal listed suffered from a prolapsed uterus or experienced any other birthing difficulties?

7. Has there been any illness, injury, or death to any other cattle owned by you in the past 36 months that were covered by mortality insurance or not?

8. Has there been any evidence of contagious or infectious disease during the last twelve months in the location where the animal is kept?

9. Has any insurance carrier ever canceled, non-renewed, or refused to insure any animal in which the applicant has or had an insurable interest?

10. Is there any other insurance on the listed animal?

11. Is the animal listed leased to others?

12. For animal listed is there a Loss Payee?

13.Are you the sole owner of the animal?

15. Do you understand that the insurance policy that you are applying requires you to give the company immediate notice of any covered animal's death, injury, sickness, or disease, along with a description of the condition and the name of the attending veterinarian? Do you also understand that failure to give this immediate notice may result in the denial of a claim?

1. Has any animal been given anabolic steroids or any other substance with or without your knowledge?

2. Has any animal ever tested positive for anabolic steroids or any other substance?