The applicant declares that to the best of the knowledge and belief of all persons to be insured that the information provided herein and any attachments made hereto are true and no material facts have been misstated or withheld. The information provided in this application shall be the basis of the policy of insurance and deemed incorporated therein.The applicant understands that any misrepresentation or false statement on this application or attachments may result in loss of coverage under any policy issued by the Lawyers Mutual Insurance Company of Kentucky. Signing this application does not bind the Applicant or Lawyers Mutual Insurance Company of Kentucky to issue the policy of insurance. The undersigned is authorized to sign this application on behalf of all persons to be insured. In accordance with KRS 304.47-030, we must give you the following notice in your application for insurance. Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime.