| (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. |