INSURANCE CLAIM NOTICE
Date Sunday, 25 January 2009 To: [Enter Addressee's Name] [Enter Addressee's Address]
Dear [Enter Salutation] You are hereby notified that I have incurred a loss which I believe is covered by my insurance policy number [Enter Policy Number] . Details of the loss are as follows: 1. Type of loss or claim: [Enter Details of Loss/Claim] Date and time incurred: [Enter Date and Time] Location: [Enter Address of Location] Estimated loss: [Enter Estimate of Loss]
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Please forward a claim form to me as soon a possible. Yours sincerely
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Name Address Telephone No. (Work) Telephone No. (Home) Policy Number [Enter Your Name] [Enter Your Address] [Enter Work Telephone Number] [Enter Home Telephone Number] [Enter Policy Number]