HomeMy WebLinkAboutPRR20165 LexisNexis - Vehicle Fire NB HWY101r —
�( ° LexisNexis- Bank of America.
P.O.BOX 740167 rr�
ATLANTA,GA 30374-0167
(678)_924-4900 FAX (678)924-4901
PAY TEN DOLLARS AND NO CENTS
PAY TO SAN LUIS OBISPO FIRE DEPT
THE FIRE RECORDS DEPT
ORDER OF 2160 SANTA BARBARA ST
SAN LUIS OBISPO,CA 93401
64-1278 /611 GA
5.1907
1072333311
$ 10.00
AMOUNT
VOID AFTER 18 MONTHS
i
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AUTHORIZED SIGNATURE
DATE 7/10/20
II'L0723333LLill 1:06LL12788ll: 335 999 8L3811'
TRAN: 1072333311 REPORT REQUEST ® LexisNexis®
P.O.BOX 740167
PLEASE CHECK A 7/10/20 ATLANTA,GA 30374-0167
CIRCLE BELOW
IIIIII II I II II ll II (678)924-4900 FAX (678)924-4901
IIIIII IIIII IIIII IIIII IIIII IIII� IIIII III�I IIIII III1I III III TOLL
00 934-9698NE:
Report Attached: TOLL FREE FAX
Report Cast: $ Number of Pages: 11800-934-6449
(including this sheet) EMAIL REPORTS:
cru.incoming@lexisnexisrisk.com
ONo Report Found with the information provided
0 No Report Written - Log entry only / Driver Exchange of Into
aLoss location not in our Jurisdiction
Suggest You Try:
O Not Releasable / Not Ready
OComments & Suggestions:
LOCATION OF LOSS HWY 101 N/B
City SAN LUIS OBISPO
Additional Information.
VEHICLE INFO
Report/Case #
Type of Report Fire Car
Date of Occurrence 7/9/20 Time
Precinct or District .
County SAN LUIS OBISPO
DRIVERS or VICTIMS INFO 1
Car Tag #.. _ State Insured Party HEATHER
Make FORD
Year. 2013
Iwi]W
VIN 1 FMCUOGX5DUA47152 Drivers Lic #
SCPOLICE or FIRE AGENCY who wrote report?
AN OBISPO FD 5.1907 J
State CA
MASSONI
SS#
State
Client 7502 Claims Adjuster M101407
Division 17TTU Claim # CAPA-01447546 KARINA CHAVEZ
Driver #2
Driver #3
Internal Codes 111111111111111111111 IN TRAN: 1072333311
Page 1 of 1
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