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Get IN State Form 54668 2011-2024

TY DAMAGE AND/OR PERSONAL INJURY State Form 54668 (3-11) Special Investigations Division INSTRUCTIONS: Anyone who has a claim for personal injury or property damage against the State of Indiana must either use this form to file a claim or make the claim in writing as prescribed in Indiana Code 34-13-3. Immunities are listed on the back of this form. 1. If applicable, include copies of accident/incident report, vehicle registration, paid receipts for repair or two (2) estimates for repair, med.

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