HomeMy WebLinkAboutPRR19344 Lexis Nexis - 6-14-19 Grand Ave vehicle incident reportLexisNexis® FAC, 793758871
P.O. BOX 740167 5.1907
ATLANTA,GA 30374-0167 On 6/17/19 we sent this request to your office I
(678)924-4900 FAX (678)924-4901 for processing. We have received NO RESPONSE.
Please research this request and Mail/Fax your reply with this
FAX BACK COVER SHEET we have provided for you. j
SAN LUIS OBISPO FIRE DEPT
FIRE RECORDS DEPT
2160 SANTA BARBARA ST
SAN LUIS OBISPO,CA 93401
THANK YOU
SECOND REQU EST
AUTHORIZED SIGNATURE
PLEASE FAX YOUR REPLY TO US AT THIS IS NOTA VAZID CHECK VnID
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1/800-934-6449
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TRAM: 793758871 REPORT REQUEST �' LexisNexis®
PLEASE CHECK A
CIRCLE BELOW
0 Report Attached:
6/17/19
11�I 111111111111 111�I 1111111111111111111111111111
Report Cost: $ NumbePages:
(inclu i sheet)
ONo Report Found with th I ration provided
No Report Written - y only / Driver Exchange of Info.
0 Loss location r Jurisdiction
Suggest You
O Not Rel CIF / Not Ready
0 96 s & Suggestions:
CATION OF LOSS 1
City
Additional Information
VEHICLE INFO
Car Tag #
Make HYUNDAI Year
P.O.BOX 740167
ATLANTA,GA 30374-0167
(678)924-4900 FAX (678)924-4901
AMERICAN FAMILY MUTUAL INS
TOLL FREE FAX: 1/800-934-6449
Re�O rtiCase #.;��°
Type of Report
Date of Ocwirr���l e 6/14/19
Time 18:36:0
State _—___CA
DRIVERS or VICTIMS INFO
Insured Party
D.O.B. SS#
VIN Drivers Lic #
LS
ICE or FIRE AG h -wrote report? ` Driver #2
N LUIS 0. .ISM-- ' - Driver #3
Client
Division 693(9aim #
Claims Adjuster
State
0001067734
Internal Code01-001-61 1 702 IRAN: 793 758871
Page 1 of 1 5.1907
AR Police Dept.: Please Return This Form With Your Res po . C E U T 9)