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Reason for close out:
Office use only:
Who provided the information?
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2 Date:
Is this a dwelling?
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1 Date:
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How many times was the insured contacted?
How many times was the agent contacted?
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Date:
Result of contact:
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Date:
Result of contact:
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Date:
Result of contact:
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Date:
Result of contact:
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Date:
Result of contact:
Name of agent:
Date:
Name of underwriter:
Did the inspector attempt to contact the insured or agent?
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Date:
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Property sold
Friday, March 03, 2034
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Wednesday, March 02, 2033
7 days ago