Scribd
Upload
39 views1 page

Repair Estimated Information Form

This document contains a repair estimated information form with details of two customers' vehicle insurance claims. It includes fields for the form number, claim date, customer name and contact details, vehicle information, insurance company, date of accident, adjuster name, deductible amount, adjuster's phone number, and claim status. The form provides high-level information about two customers' vehicle accident insurance claims filed with Alliance Insurance in August 2017.

Uploaded by

YUGENDRAN
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
39 views1 page

Repair Estimated Information Form

This document contains a repair estimated information form with details of two customers' vehicle insurance claims. It includes fields for the form number, claim date, customer name and contact details, vehicle information, insurance company, date of accident, adjuster name, deductible amount, adjuster's phone number, and claim status. The form provides high-level information about two customers' vehicle accident insurance claims filed with Alliance Insurance in August 2017.

Uploaded by

YUGENDRAN
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
You are on page 1/ 1

REPAIR ESTIMATED INFORMATION FORM HISTORY

form Claim customer vehicle insurance Date OF AMOUNT OF ADJUSTER PHONE


Num. Date Number Customer name customer ic Num. contact Num Customer Adress Email number company Accident adjuster name DEDUCTEBLE NUMBER STATUS INSURANCE

REI1233 8/2/2017 167AE786 Yugendran a/l Subramaniam 000326-07-0835 012-367-8910 Lot 67,TAMAN TENAGA Yugen08rider@gmail.com WEA7006 ALLIANCE 7/28/2017 SUNG GARAK RM 10 , 000 014 2377966 CLAIMED

REI1234 8/3/2017 167AE443 Mohamad Hairil bin Herman 990313-06-5901 018-6636046 B-05-18 PPR HILIRAN AMPANG hairilhery46@gmail.com WKU4434 ALLIANCE 7/21/2017 LIN CHONG WEI RM 10 , 000 016 2812038 CLAIMED

Page 1 of 1

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy