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Witness Card (english)

Did you see the accident?

Did anyone appear injured?

Were you riding in a vehicle involved?

Which one?

Who do you think was responsible for the accident?

Your name:

Address:

City/State/Zip:

Phone:


Witness Card (spanish)

Usted vio el accidente?

Fecha

Lugar

Hubo algun herido?

Era usted pasajero en algun vehiculo del accidente?

Cual vehiculo?

En su opinion, quien tuvo la culpa en el accidente?

Su nombre?

Direccion?

Ciuda, Estado , Codigo postal

Telefono (trabajo)

(casa)

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1795


HOURS: Monday Friday 8am to 5pm CST

Toll-Free - 800.725.7984
Main - 972.594.0887
Fax - 972.659.0713
Emergency After Hours - 972.594.0887





CARDS AND CERTIFICATES
Truck ID Cards
Contact us with your account information
Insurance Certificates
Contact us with your account information




FORMS
Accident Report: The Insured
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Accident Report: The Witness
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Quick Quote
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Custom Quote
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