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scan0003 - fredoniaphysicaltherapy.com · NEW YORK MOTOR VEHICLE NO-FAULT INSURANCE LAW ASSIGNMENT OF BENEFITS FROM (FOR ACCIDENTS OCCURRING ON AND AFTER 03/01/02) ("Assignor") hereby

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Page 1: scan0003 - fredoniaphysicaltherapy.com · NEW YORK MOTOR VEHICLE NO-FAULT INSURANCE LAW ASSIGNMENT OF BENEFITS FROM (FOR ACCIDENTS OCCURRING ON AND AFTER 03/01/02) ("Assignor") hereby

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