ASSIGNMENTS.

[FIGURE] An ASSIGNMENT of this Policy is to be made only when, by virtue of a voluntary transfer or conveyance, a change has
taken place in the title or ownership of the property covered by the Policy. In such case, the consent of the Company having
been previously obtained, the form subjoined should be used in making the assignment.

[FIGURE] When it is desired to make the insurance hereunder payable to a third party, as collateral security, an entry must be
made in the body of the Policy, in terms substantially as follows: "At the request of the Assured, the Loss under this Policy,
if any, is made payable to (state the name of the mortgagee or trustee, as the case may be,) [blank]
to extent of his mortgage interest, not exceeding the sum insured."

THE ASSURED under this Policy having applied for permission to assign the same to [blank]
by a reason of transfer of the title or ownership of the property covered by this Policy to said
part [blank], the HOME FIRE INSURANCE COMPANY OF UTAH hereby consents to such assignment, subject to
all the terms and conditions of insurance herein mentioned and referred to.

Dated the [blank] day of [blank] 18[blank]. [blank]

For Value Received, (consent having been first obtained, as above certified,) [blank] hereby transfer, assign
and set over unto [blank] and [blank] assigns, all [blank] right, title and
interest in this Policy of Insurance, and all benefit and advantage to be derived therefrom.

Witness [blank] hand this [blank] day of [blank] 188[blank].
[blank] ASSURED.

RECEIPT FOR CANCELLATION.

[blank] 18[blank]

Received of the HOME FIRE INSURANCE COMPANY OF UTAH,
[blank] DOLLARS,
Return Premium, in consideration of which, this Policy is hereby canceled and surrendered to the Company.

[blank]
The Assured by said Policy.