N.M. Admin. Code § 13.7.3.11

Current through Register Vol. 35, No. 24, December 23, 2024
Section 13.7.3.11 - COMPLAINT RECORD - FORM

NAME OF COMPANY: _______________________________

A B C D E F G H
Function Code Reason Code Line Type Company Disposition After Complaint Receipt Date Received Date Closed Insurance Department Complaint State of Origin
Company Identification Number
Agents Number Staff
Adjusters Number
Independent Adjuster

N.M. Admin. Code § 13.7.3.11

7/1/97; Recompiled 11/30/01