Property Assignment Form
Please note: yellow fields are required to be filled in.
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Your name
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Company
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Address
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City
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State
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ZIP code
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Email
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Phone
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Fax
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Assignment Type
| Full assignment - please handle to conclusion. | |
| Task assignment - please complete the following tasks: |
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Estimate of Damages
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Photos of Damage
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Diagram
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Contents Inventory
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Agreed Price
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Scope of Loss
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Determine Cause of Loss
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Insured Recorded Statement
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C & O Investigation
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ITV Report
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Non-Waiver Agreement
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Proof of Loss
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Obtain Official Reports:
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Other:
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Policy Information
(Select one)
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Claim Information
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Claim number
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Date of Loss
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Time of Loss
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Location of Loss
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Description of Loss: |
Further Information or Instructions: |
Attachments
(Maximum size of 5 MB)