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Get and Sign Geico Wage and Salary Verification 2004-2022 Form
INSURANCE COMPANIES
WAGE AND SALARY VERIFICATION
DATE
OUR POLICYHOLDER
DATE OF ACCIDENT
CLAIM NUMBER
Employee’s Name
Employee’s Address
Dear Sir or Madam:
The above named person sustained injuries as a result of an automobile accident on the date indicated. We understand this person is
your employee or former employee. To determine what monies may be due to the injured party, please provide us with responses to
the following questions, and return this form promptly. Thank you for your...
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