📄 Extracted Text (147 words)
Precedence: ROUTINE Date: 12/09/2009
To: Miami
From: Miami
Contact:
Approved By:
Drafted By:
Case ID #: 72B-MM-11327 (Pending)
188B-MM-105207-C (Pending)
Title: VICTIM NOTIFICATION FORM
Synopsis: To document business information.
Reference: 72B-MM-111327 Serial 1
Details:
VnsCase#: 72B-MM-111327
CAgtName:
BusName :
BusEIN :
BusAcct :
SSAN :
VicDate : 20091023
VicDOD :
VicMinor: N
DOB :
Race : U
Sex : U
Fax .
•
VWrkAddr:
VWrkadd2:
VWrkCity:
VWrkSt :
VWrkCtry:
VWrkZip :
WEmail :
WPhone :
WFax .
•
VicPager:
NOKFirN :
NOKMidN :
NOKLastN:
NOKRel :
EFTA00108679
NOKAddr :
NOKAddr2:
NOKCity :
NOKState:
NOKCtry :
NOKZip :
NOKHEma1:
NOKWEma1:
NOKHPho :
NOKWPho :
NOKHFax :
NOKWFax :
NOKPager:
GrdFirN :
GrdMidN :
GrdLastN:
GrdRel :
GrdAddr :
GrdAddr2:
GrdCity :
GrdState:
GrdCtry :
GrdZip :
GrdHEmal:
GrdWEma1:
GrdHPho :
GrdWPho :
GrdHFax
GrdWFax :
GrdPager:
PropRet :
TotLoss : 000000000
Lang. :
Disable :
* *
EFTA00108680
ℹ️ Document Details
SHA-256
c752566f72a18a2ced3263d95bb8ffbf875880a6878bf87800f51da9b7172289
Bates Number
EFTA00108679
Dataset
DataSet-9
Document Type
document
Pages
2
Comments 0