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Please fill out the assignment form to the best of your ability and we'll get to work, making the investigation experience effortless and effective. If you'd prefer to contact us directly via email or phone, please feel free to drop us a line at info@fairleadgroup.com or 862-339-4318. Most of the fields that follow are optional but please include as much information as possible for an efficient investigation.

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DOB:

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Claim Information

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