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CREDIT VALLEY APPRAISAL REQUEST
*FROM CO.:
Farmers' Mutual Insurance
other
If other, please specify company
*ADDRESS / CITY:
336 Angeline Street South PO Box 28, Lindsay, ON. K9V 4R8
other
If other, please specify address
*ADJ:
*TEL # / FAX #:
A value is required.
Invalid format.
*CLAIM #:
*DOL:
*DED.:
*POLICY #:
*INSD NAME:
*INSD TEL# WK/HM/CELL
*LIC.#
*YEAR:
*MAKE
*MODEL:
*SER#:
*DAMAGE AREA:
*LOCATION:
*CONTACT:
*COMMENTS:
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