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Uniform Mitigation Verification Inspection Form Maintain a copy of this form and any documentation provided with the insurance policy Inspection Date: 02/29/2012 Owner Information Owner Name: Village

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1. Start by writing the recipient's name on the first line. This is the person or organization who will be receiving the mail or package.
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3. On the third line, write the city where the address is located. This could be the city name, such as "San Francisco," or a specific neighborhood within the city.
4. After the city, write the state abbreviation. For example, if the address is in California, you would write "CA" here.
5. Finally, write the ZIP code on the last line. This is a series of numbers that helps to further identify the location. In this case, it would depend on the specific ZIP code for 1745 Harrison Street.

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