5 ABORN STREET_CLAIM MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723.3800 Ma Only(800)392.6108.FAX(800)851.8424
3/25/2023
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws Ch.139 Sec.3B
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
SALEM MA 01970
Re: Insured: FAITH AROKO AND MICHELLE AROKO
Property Address: 5 ABORN STREET. SALEM, MA 01970
Policy Number: 1439971
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 03/15/2023
Claim Number: 471799
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed$1000.00 or cause Massachusetts General Laws Chapter 143 section 6 to be applicable. If any
notice under Massachusetts General Laws Chapter 139 Section 3B is appropriate, please direct it to the
attention of the writer and include a reference to the captioned insured, location, policy number, date of loss
and claim or file number.
MPIUA Claims Division
OA00021
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