1990
PACE
AR~OW
EMERGENCY
AND
IDENTIFICATION INFORMATION
Before
we
explain
how
things
work,
take
a
few
minutes
to
fill
in
the
information
on
these
two
pages.
It'll
be a
handy
reference
for
you
in
the
future.
Your Name
______
--------------------~~------~~------------~----------------
Model
__________________________________
~
____________________________________
_
Dealer
Name
__________
'--"
______________
--'
______________________________
__
Address
_______________________________________________
__
Insurance
Policy
Company
_________________________________________________
___
Agent
Name
________
-------------------------'---------------------
Telephone
______________________________
-"
______
-------------~-----
Policy
Number
________________________________
'--
_______________
_
RangeiOven
Manufacturer
__
~
_________________________________________
_
Model
______________________________________________________
_
Serial
Number
________________________
~
__
~
________________________________
_
Refrigerator
Manufacturer
_____________________________________________________
__
Model
_______________________________________________________
_
Serial
Number
________________________________________________________
_
Furnace
Manufacturer
__________________________________________________
__
Model
__________________________________________________
_
Serial
Number
_______________________________________________________
___
4