HomeMy WebLinkAbout07-19-2023 PRR23204 LexisNexis - Car Fire Report Calle JoaquinLexisNexis® BankofAmerlica.s
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INI
PAY TO
THE
ORDER OF
TEN DOL
SAN LUIS SO FIRE
FIRE REC DS FPq
2160 SAN BARBARA
SAN LUIS BISPO,CA 934U1
DATE 7/13/23
33P302137820
5.1907
1
$ 10.00
AMOUNT
VOID AFTER 18 MONTHS
M TRAN: 2219191961
REPORT REQUEST
LexisNexis®
Agency q nfo
0 7
ATLANTA GA 3
0374 0167
7/11 /23
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TOLL FREE PHONE
Date of Occurrence
1.800.934.9698
Report/Case # UNKNOWN
TOLLFAX
9EE
9
Type of Report Fire Car
EMAILTO
cru.incom ng@I x'IRsnexiisrriisk.comm
Agency Name SAN LUIS OBISPO FD
Vehicle
Info
Precinct or District SAN LUIS OBISPO, CA F
VIN _ _
4S4BTANC1 L3173582
City of Loss SAN LUIS OBISPO
Car Tag
_ 1 TOADY1 _Tag State 2020
County of Loss SAN LUIS OBIS@Qte
CA Make
SUBA Year _ CA
Location of Loss CALLE JOAQUIN ROAD
Additional Info
Outcome of Search (Mark below and Return This Form)
Involved Parties
Report Attached:
MICHELLE C LEICESTER-CADARET Pages (Including this sheet)
Insured Party _ -
O No Report Foun
Date of Birth SS# _ O No Report Written - Log entry only/Driver Exchange
Driver's License License State O Not Releasable / Not Ready
Driver #2 O Unable o locate Report in our Jurisdiction"
SuggestY try: — - -
Driver #3 O Comments
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Client 8126 Claim # 803324-GO
Division
AR Page 1 of 1
Claims Adjuster USER:9978
JAN SHORE
7/13/23 R 5.1907