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Description of INDIANA
DATE MM/DD/YYYY INDIANA PERSONAL AUTO APPLICATION AGENCY APPLICANT S NAME AND MAILING ADDRESS Include county ZIP 4 NAIC CODE TELEPHONE NUMBER CO/PLAN CODE POL SUBCODE AGENCY CUSTOMER ID EFFECTIVE DATE RESIDENCE CURRENT RESIDENCE IS YRS AT ADDR PREVIOUS ADDRESS If less than 3 years CURR PREV OWNED EXPIRATION DATE VEH YEAR TOTAL NUMBER OF VEHICLES IN HOUSEHOLD MAKE MODEL AND BODY TYPE COST NEW SYMBOL AGE GRP PASSIVE...
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