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General Information

989-975-8484

jvanderpoel@mihomepaper.com

mihomepaper.com

Miscellaneous

Ads in this issue

Text from ad:

Please fax this back the
day the inserts drop, then
mail the original.
AFFIDAVIT OF INSERTION
JANE VANDERPOEL
SANILAC COUNTY NEWS
432 S. SANDUSKY ROAD Secondary Contact:
SANDUSKY, MI 48471
PHONE: 810-648-4000 PHONE:
FAX: 810-648-4526 FAX:
EMAIL: jvanderpoel@mihomepaper.com EMAIL:

Please refer to Media Resources Insertion Order #: 217-0154LLS-06
This is to certify that 5,270 inserts from LIFE LINE SCREENING
( Quantity )
with Source Code: were inserted in the Wednesday, June 21, 2017
FFSC193
( Publication Date )

issue of the SANILAC COUNTY NEWS in SANDUSKY, MI 48471
( Paper Name ) ( City, State Zip )

( SIGNED )

( DATE )
NOTARY PUBLIC
If you do not have Notary on staff, or charge for Notary, two signatures are fine. We will not pay for Notary.

Sworn to and subscribed before me this day of

A.D.
( Notary Public Signature )

( My Commission Expires )
( Please include your Notary Seal and/ or stamp )

How many different advertisers placed inserts in the newspaper on this day?

Were you able to run the press release? Press Release Page/Section (ex: A5):
If yes, please send tearsheets with affidavit to address below.

Did any competitor inserts run in the newspaper on that day?

Please have this Affidavit of Insertion filled out after inserts run, notarized and mailed to the following
address. If you do not have a Notary on staff, two signatures are fine.
AOI
ATTN:
Media Resources, LTD.
4450 Belden Village St. NW, Ste 502
Canton, OH 44718
Please direct any questions regarding this insert to SAMANTHA BURWELL or TARA LONG at (330) 492-1111.
Thank you for your time, understanding and cooperation.
Media Resources, LTD. . 4450 Belden Village St. NW, Ste 502 . Canton, OH 44718
Phone: (330) 492-1111 . Fax: (330) 492-8472

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