#3600
@001 Enter the name of the insurance company:
@002 Enter the name of the insured:
@360/@360/@360/@360 Enter nature of peril resulting in claim:
Automobile collision
Fire
Theft
KEY IN VALUE
@361/@361/@361 Enter the type of coverage claim was paid under:
Automobile Collision/Comprehensive
Homeowner's
KEY IN VALUE
!362 Enter the amount of the claim in numerals:
!363 Enter the amount of the insured's deductible in numerals:
#3601/#3602 The insured's deductible:
Will be collected by the insuror
Will be retained by the insured
#3603
#end control section
#3600
/* para. 3600: Insurance Subrogation agreement */

			SUBROGATION AGREEMENT


WHEREAS, on ____________________, @001, an insurance company,
was presented with a claim arising from:

@360


under insurance coverage provided to @002, under its coverage
for:

@361,


and,

WHEREAS, on _________________________, @001 paid a claim in an
amount of $ @362 (!362 dollars), with a deductible of  $ @363
(!363 dollars), arising from the perils and covered by the policy
stated above, NOW, THEREFORE:


@002, his heirs and assigns, herewith assign and convey to
@001 and any all rights against any entity who may be liable
to @002 for the loss stated above.


@002 shall pursue any and all responsible parties at its own
expense, and may at its option, bring such action in its own
name or that of @002.


@002 herewith covenants and agrees to fully assist @001 in
pursuit of its rights of subrogation herein.
#3601
/* Para. 3601: Deductible */

@001 may at its option pursue the deductible loss of @002.
In the event that @001 does so, it shall notify @002, and,
further, @002 agrees that if any recovery is made that it
will share in all costs related thereto pro rata.                                
#3602
/* Para. 3602: Deductible by insured */

The insured shall retain separately its rights to recover
the deductible loss.
#3603

/* Para. 3603: Closer */

@002 further agrees not to release or exonerate the adverse
party or parties or enter into any compromise with them
without the prior approval of @001. @002 shall execute any
and all instruments reasonably required by @001 in connection
herewith.


Date: _____________________________________





___________________________________________________

@002