Claim ID: 16509
Submitted: Nov-16-2018
Requested Processing: Photos required
Name: Janesax
Email: mwojcik@probbox.com
Company: google
Phone: 89593768516
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1975-11-11
Insured Address: San Jose
Insured Telephone: 88885632394
Claimant Address: San Jose
Claimant Telephone: 81125495249
Loss Location
USA
Local Authorities:
Loss Description: ventolin hfa inhaler
Handling Instructions: ventolin hfa inhaler