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Effingham, IL

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Effingham, IL

Fire and Rescue
Request a fire incident report

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Request a fire incident report

Name of person or company involved(Required)
Date of incident(Required)
Month
Day
Year
Time of incident

: Hours

Minutes

AM/PM AM/PM
Describe the incident location(Required)
Provide an address, intersection, or other location description
Type of incident
- Structure fire
- Motor vehicle accident
- Vehicle fire
Driver name
First Last
Driver address
Street Address Address Line 2 City State ZIP Code
Your name(Required)
First Last
Your phone number(Required)
Your email(Required)
Reason for report
- I am the vehicle owner
- I am an insurance adjuster
- I am a representative for an insurance company
- I am an attorney
How do you want to get the report?(Required)
- Email
- Mail
Email(Required)
Address(Required)
Street Address Address Line 2 City State ZIP Code
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