HomeMy WebLinkAboutPRR23170 LexisNexis - 1411 Descanso Fire(O'LexisNexis- BankofAmerica,
P.O. BOX 740167 111W
ATLAI%TA,GA 30374-0167
678.924.. 900 FAX 800 34 6449
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PAY TEN D LLA, SAND NO CETS
PAY TO S N L IS Q$ISPO IRE D PT
THE FI EC RIDS D PT
ORDER OF 216 NTA� ARA ST
SAN IS OBI O,CA 934 1
DATE 6/19/23
5 1907
i
$ 10.00
AMOUNT
VOID AFTER 18 MONTHS
AUTHORIZED SIGNATURE
TRAN: 2193650961 REPORT REQUEST ' LexisNexis-
Agency
Info
Date of Occurrence 6/19/23
Report/Case #
23-03663
Type of Report
Fire Building
I Agency Name SAN LUIS OBISPO FD
`Precinct or District
City of Loss SAN LUIS OBISPO
P.O. BOX 740167
ATLANTA,GA 30374-0167
Illy f[l lE l� 11 IIII IIII IIIII Illll IIII! lull II I I I TOLL FREE PHONE
1.800.934.9698
TOLL FREE FAX
1.800.934.6449
EMAIL REPORTS TO
cru.incoming@lexisnexisrisk.com
Vehicle Info
VIN
Car Tag
County of Loss SAN LUIS OBISP.Iqate CA Make
Location of Lass 1411 DESCANSO ST
Additional Info MATTIE BLISS 805-540-4413 (CELL) AND 805-781-7383 (OFFICE) MB
Involved Parties
Insured Party
cense State CA
Tag State
Year
Outcome of Search (Mark below and Return This Form)
Report Attached:
Report Cost I # of Pages (Including this sheet)
O No Report Found
O No Report Written - Log entry only/Driver Exchange
O Not Releasable / Not Ready
O Unable to locate Report in our Jurisdiction"
Suggest you try:
O Comments
'This request may include confidential information. As an entity authorized to receive this information you agree that after responding to
LexisNexis you will appropriately protect this information against any unauthorized reading, distribution, copying or other use. If you do
not have a report for this request, please return this form to LexisNexis and then immediately destroy any copies.
LexisNexis Internal Use Only Below This Line
Client 6725 Claim # 053863028-01 Claims Adjuster N1507040
Division
JOSH LINSON
AR Page 1 of 1 6/19/23 R 5.1907