中国平安人寿保险股份有限公司十堰中心支公司空白保单，流水号 py09000700165308,py09000700165311—py09000700165316,py09000700165320—py09000700165321,py09000800082537,py09000800195696,py09000800195957,py09000800196061,py09000800072279,py09000800072285,py09000800446051—py09000800446052,py09000800446059—py09000800446060,py09000800446109—py09000800446116,py09000800446118—py09000800446120,py09000800446122—py09000800446130,py09000800446155,py09000800446425,py09000800446545,py09000800552993,py09000800553215,py09000800553274,py09000800553279；空白发票流水号：b24200063009130067005,b24200063009130067008—b24200063009130067013,b24200063009130067017—b24200063009130067018,b24200063009130067027，以上单证已遗失，特此声明。