**CLAIM ABSTRACT**

**COMPANY NAME:** NATIONAL INSURANCE
**P.A. CODE:** 0711/84
**DATE:** 07/11/84
**SOURCE:** DMK 37

**INSURED:** TLD ORCHARD, N
**PRODUCT:** CL 028272
**PREP:** POLICY
**POLICY:** V033117

**LOCATION:** NEW YORK, NY 10560
**VCC/LOPS DATE:** 05/21/82
**VOL./PC:** 05/21/83

**PRODUCER:** STEPHENSON, E. HIGGINS
**TIME:** 11/19/82
**VOL./EXP:** 05/21/83

**NATIVE OF:** MONTGOMERY, AL
**VAST DRAMA, NJ 10000 AM**
**INDUSTRY:** VETERAN INDEP.

**CUMULATIVE A.MIL END P.TTL:** LESS PAYEE/STHORNS
**VETRAN ANALYSIS:** NN

**PRODUCT:** NONE
**INSURED DIVISION:** NONE

**PURPOSE:** NONE
**LOCATION:** NONE

**STATUS:** PRIVATE: $51
**LOSS:** $4305
**REPORT DATE:** 04/28/82

**SYSTEM:** CLAIMS/PERS PAYE
**OCCUPATION:** MJIC
**MEDICAL STATUS:** N

**NAME:** KENNETH LEVY
**AGE:** 30
**DEPARTMENT:** 52
**DEBILITY:** MEDICAL
**DIRECT:** 198-
**SECTION:** 0
**RESERVE:** RESERVE
**NUMBER:** 12300
**AMOUNT:** 0.00
**PROFIT UNIT:** 0.11%
**RESPONSIBILITY:** 0.01
**PROFIT RATIO:** 0.01

**REINS CO. TYPE:** INTER CERTIFICATE
**CORE NUMBER:** 9999
**CELL/INDEX:** FLOR
**PART:** PCT.
**PCT.:** 0.00
**PD:** 0.00