Acknowledgment Of Assignment

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Form 2240F© 2004 Nationwide Publishing Company, Inc.http://www.claimspages.comACKNOWLEDGMENT OF ASSIGNMENT AND PRELIMINARYREPORT(This Report to be Mailed Immediately After First Inspection)TO:ADJUSTER’S FILE NUMBERDATEINSURED:LOCATION:AGENCY: LOCATION:POLICY NUMBER:...

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