| (vi) A signature card from a financial |
| institution or credit union authorizing the |
| employee to sign checks on a business |
| checking or share draft account that is at |
| least 6 months old; a notarized affidavit |
| from the employer describing the duties of |
| the employee and the average number of |
| hours worked by the employee and attesting |
| that the employer is not defrauding the |
| carrier and is aware of the consequences of |
| committing fraud or making a material |
| misrepresentation to the carrier, including |
| a loss of coverage and benefits; and, if |
| the group coverage is purchased through a |
| producer, a notarized affidavit from the |
| producer affirming the producer's belief |
| that the employer qualifies as an eligible |
| group for coverage. |