HomeMy WebLinkAboutPRR19390 Fissell - 1301 Carmel Fire Report"PLEASE RETURN THIS SECTION WITH REPORT 778927
PRS, Inc.
P.O. Box 456
Chandler, AZ 85244-0456
(800) 304-6730 Fax (800) 304-0301
Report #:
Special Notes:
Type of Loss: Structure Fire
Officer or Badge #:
Date of Loss 10/6/2019
Time of Loss:
Location of Loss: 1301 CARMEL ST
City State: SAN LUIS OBISPO, CA
Parties Involved
Insured Party Name: Jeremy Fissell
DL#/State:
Plate #/State:
DOB:
SSN: xxx-xx-
Additional Info:
Other Type of Loss:
REPORT REQUEST
If possible, please fax report
with this sheet to our toll free
fax: (800) 304-0301
or email to
Inbox@PRSPublicRecords.com
— PRS, Inc. Use Only
Date Requested: 10/8/2019
Order #: 784946 *Used for Insurance purposes only*
Claim #: 682306 -GJ
Investigating Agency: San Luis Obispo Fire Dept., CA
Party #2 Name:
DL#/State:
Plate #/State:
DOB:
SSN: xxx-xx-
****REPORTING AGENCY USE ONLY****
❑ Unable to locate report with info provided ❑ No report written (If call card please provide copy)
❑ Not our jurisdiction - Suggest you try:
Report cost $
PRS, Inc.
P.O. Box 456
Chandler, AZ 85244-0456
(800)304-6730
(Please fill in the amount of your fee here and also on the check
BMO HARRIS BANK, N.A.
Phoenix, Arizona
91-404
1221
778927
Pay TEN DOLLARS AND 00 CENTS Date 10/8/2019 Amount $10.00
San Luis Obispo Fire Department
2160 Santa Barbara Ave.
To The
Order Of San Luis Obispo, CA 93401
Attention: Records Department
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Void after 90 days
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