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service@theinfoagency.com
(214) 377-4930
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The Info Agency Case Submittal Form
Company Name:
Claim Handler Name:
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Claim Handler Email:
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Phone:
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File of Claim #:
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Subject Full Name:
Subject Phone Numbers:
Subject Address:
Subject DOB
Subject SSN:
Date of Injury:
Injured Body Part:
Notes:
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Headquarters
The Info Agency
Dallas, TX 75240
Phone:
214.377.4930
Fax:
214.377.4931
