Automobile Loss Notice
NO COVERAGE OF ANY KIND IS BOUND BY SUBMITTING INFORMATION VIA THIS ONLINE FORM. Completion of this form does not constitute an actual claim, but serves to notify your agent of an existing loss or claim.
By completing this form, you are acknowledging your understanding of and agreement with these term
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Ogino-Aizumi Insurance Agency 1818 W. Beverly Blvd., Suite 210 Montebello, CA 90640 Phone: (323) 728-7488 Fax: (323)724-5611 Email: paul@oginoaizumi.com
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