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32646 Five Mile Road
Livonia, Michigan 48154
Ph: (734) 522-3900
Fax: (734) 421-1777
Toll Free: (800) 522-4030
email: info@metroagency.net


Claim Form
CLAIM INFORMATION FORM
Name:
 Address:
Daytime Phone:
 Alternate Phone:
Policy Number
  
CLAIM DESCRIPTION:
(If Auto Claim, provide description of vehicle - year make model)
Estimate Amount

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