| Claim ID: | 17617 |
| Submitted: | Dec-03-2018 |
| Requested Processing: | Photos required |
| Name: | Mansax |
| Email: | albanithemo@regiopost.trade |
| Company: | |
| Phone: | 87957354833 |
| Their Claim No.: | |
| Insured: | |
| Policy No.: | |
| Date of Loss: | 1977-11-10 |
| Insured Address: | New York |
| Insured Telephone: | 82748961463 |
| Claimant Address: | New York |
| Claimant Telephone: | 82988415695 |
| Loss Location | USA |
| Local Authorities: | |
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