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Property Policy Change

Name:  
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Effective Date of Change:  

What change do you want to make?
Please be as specific as you can to help us process your request easily.

Note: By submitting this form you understand that no coverage is bound until you receive written notice. You also agree to release us from any liability if this information is accidentally viewed by unauthorized persons. We will only use this information for insurance quoting purposes and not distribute to other parties.


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Assurant



JWB INSURANCE
Kelly A. Smith, owner/agent
PO Box 877
324 East Highway, Suite B
Holdenville, OK  74848
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Phone: 405-379-3395
Fax: 405-379-2127
Toll Free: 800-979-3395
Emergency: 405-380-3178
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