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					DAMAGE REPORT
Date: Copy: DAMAGE DETAIL’S October 01, 2009 Time: File : 13:34 Hrs

Natural Disaster
Name of Person

Human Error

Mistake

Home Address

Location of Damage

Damage Reported By

Date of Damage

October 01, 2009

Time of Damage

12:00 Hrs

Details of Damage

How did the Damage Occur

Comments

ACCOUNT DEPARTMENT

Purchase Date

October 01, 2009

Purchase Price

Supplier

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