Gresham Outlook. W ed.. June 16 1982; Sandy Post, Thurs., June 17, 1982 _7
ACCIDENT REPORT
WALRAD
INSURANCE
AGENCY, LTD
105 N t Roberts, Gresham
WHAT HAPPENED?
»TA U
667-4171
TA «M
»TATI RAMM
I N U M A NCI
COMTANM»
HOAM
M
IN lU ltN C I
Merle W. Scrivner
21951 se Stark
Gresham
661-5205
OTHER DRIVER’S NAME
: rosby
n avidi
15 NE 10th
ADDRESS____________
CITY ________________
Gresham
665-3797
STATE
PHONE
DRIVER S LICENSE NUMBER
OTHER ID
JON
CASEY
MARK AREA OF DAMAGE
A
21551 S.E. Stark
Gresham
IT A T I FA IM
IN U M A N O
COAMANM*
661-1551
c
5
KEN
ARENDS
GENE FENSKE
19245 E. Burnside
665-3111
55 E. Powell
Gresham
"See me for cor,
home, life, health &
business insurance."
ITATI 'AMM
■J&,
®sw»
Wherever
You Go,
There’s A
Farmer’s Agent
Ready To
Help You.
665-4149
Driver's Side
Passenger Side
HERB
WHITE
IT A T I TAMM
IN U M A N O
COMPAMtfl
OTHER DRIVER'S INSURANCE CO.
655 W Burnside
Wes Gresham OMice
AGENT S NAME _______________
ADDRESS______________________
PHONE
667-4600
POLICY NUMBER
OTHER DRIVER'S SIGNATURE
VILLAGE
INSURANCE
DATE
DAY
Terry Cleys
Don Gould
Kenn McManus
2482A E. Burnside
Gresham
WEATHER CONDITIONS
FILL OUR BELOW A N D KEEP THIS FORM IN YOUR CAR . . .
YOUR NAM Et.
CITY
STATE
______
ADDRESS
___ ZIP
PHONE
667-1481
INSURANCE COMPANY
AGENT S NAME
IT A T I T A IN
A
<£M9
NOAM O T F K It
_____
POLICY NUMBER
YOU MUST REPORT YOUR ACCIDENT
WITH THE POLICE YOURSELF WITHIN 72 HOURS IF NO INJURIES.
NORMAN A PAYNE
23842 NE HA»)
Wood Village OR
667-7002
Your Local
Insurance
Agents
Urge You To
DRIVE
SAFELY