AIG Ireland Limited AIG House Merrion Road Dublin 4 Tel: 208 1400 Fax: 283 7773 E-mail: email@example.com
WINDSCREEN CLAIM FORM
Name of Insured ___Policy No. ___ Address ___Home Phone No. ___ Business or Occupation ___Work Phone No. ___ Is the Insured registered for VAT? Yes No
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