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| Company Name: | UNITED OF OMAHA LIFE INSURANCE COMPANY |
| Employer identification number (EIN): | 470312211 |
| National Association of Insurance Commissioner's ID: | 69868 |
| NAIC Classification: | 69868 |
| BALFURD CLEANERS, INC. | BALFURD INC. WELFARE BENEFITS PLAN | 2016-06-01 |
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