JAGGASSUR

Client Area — Family Liability Claim Declaration

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Circumstances

Date of the incident

Location

Description of events

The police intervened

Police report number

Details — Family liability Third party involved Damage caused Estimated amount

Attachments Photos, accident report, documents (optional)

You can select multiple files.

Contact

Contact email

Contact phone

JAGGASSUR SNC — FSMA n° 0798.400.169 — Rue Oscar Sturbois 7, 7021 Havré, Belgium