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Get NY State Farm 121073.3 2006-2024

Ion: Year Make Model Claim Number: VIN Date of loss: to estimate and repair my vehicle, unless it is an economic total loss. I authorize(d) (Repairer) Vehicle Owner’s Signature Date Date the vehicle is available for inspection: Date I have received a copy of the initial and final automated repair estimate. I authorize State Farm® to pay (Repairer) $ on my behalf. Vehicle Owner’s Signature Date I certify that repairs have been completed as indicated on the final automated rep.

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