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Motor claim application

Claim type

Owner of Your vehicle

Please enter only numbers
LV-

The holder of Your vehicle

Please enter only numbers
LV-

Your vehicle driver

Please enter only numbers

Your vehicle data

Other parties concerned (if any)

Event description

Exact time: :

The remaining number of characters:

The remaining number of characters:



Please pay the insurance indemnity

Claimant

-Please enter only numbers
Type of decision:*

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