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Valuable Articles Purchase Form
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Valuable Articles Purchase Form
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To notify us of the purchase of a valuable article, please complete the information below. The article is not covered until you have been notified by BWD that your coverage has become effective.
 
INSURED INFORMATION
First Name :  *
Last Name :  *
Address :  *
City :  *
State :  *
Zip :  *
Email :  *
Phone :
Fax :

PERSONAL ARTICLE INFORMATION
Location :  *
Item Number :  *
Property Class :  *
Description :  *
Serial Number :  *
Purchase/Appraisal Date :  *
Value of Item :  *
Is it contained in a vault? :
76 South Central Ave Valley Stream, NY 11580 P: (516) 284-0118 F: (516) 791-7272
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