71 Valley Street - Claim Notice 21222 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(61717233800 Ma Only(800)392.6108. FAX(800)851.8424
2/12/2022
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139,Sec.313
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
SALEM MA 01970
Re: Insured: LAKSHMIDEVI SREERAMAREDDY
Property Address: 71 VALLEY STREET. SALEM, MA 01970
Policy Number: 1437465
Type Loss: Vehicle Damage
Date of Loss: 02/04/2022
Claim Number: 463539
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
CMA00021
MAR 7 pm.4:09