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Texas Department of Insurance Property Casualty AutoMobile / Homeowners MC 104-1A 333 Guadalupe P. O. Box 149104 Austin Texas 78714-9104 512- telephone 512-490-1015 fax www. tdi. state. tx. us ROOFING INSTALLATION INFORMATION AND CERTIFICATION FOR REDUCTION IN RESIDENTIAL INSURANCE PREMIUMS NOTICE TO HOMEOWNER. Completion of this certificate will entitle you to a reduction in your residential insurance premium. This certification form is solel.

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