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Call us! 620-792-4515
Toll Free: 866-792-4515

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Motor Vehicle Report Request

REQUIRED BY ALL EMPLOYEES DRIVING COMPANY VEHICLES OR PERSONAL VEHICLES
Fill out the Motor Vehicle Report Request and fax to: Goss Insurance at 316-793-3311.

Click to download the appropriate form. [pdf]  [.doc]

1911 Lakin Avenue
Great Bend, KS 67530

Phone: 620-792-4515
Fax: 620-793-3311

Phone: 620-792-4515
Toll Free: 866-792-4915
Fax: 620-793-3311

1911 Lakin Avenue
P.O. Box 1910
Great Bend, KS 67530-1910

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