| Name | Description | Type | Additional information |
|---|---|---|---|
| ClientId | string |
None. |
|
| InsuranceCompany | string |
None. |
|
| Address1 | string |
None. |
|
| Address2 | string |
None. |
|
| Address3 | string |
None. |
|
| City | string |
None. |
|
| State | StateCodeEnum |
None. |
|
| PostalCode | string |
None. |