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New Assignment
Please complete the applicable fields below and we will confirm the assignment with you shortly.
"*" indicates required fields
Date
*
Insurance Company
*
Is this a rush assignement?
*
Is this a rush assignement?
A
Yes
B
No
Claims Adjuster
Name
Email
Phone Number
Person Making Assignment (if different then above)
Name
Email
Phone Number
Claim Information
Claim #
*
File #
Signed Documents Needed? (If Yes, Submit Documents)
Signed Documents Needed? (If Yes, Submit Documents)
A
Yes
B
No
Notary Required?
Notary Required?
A
Yes
B
No
Date Of Loss
*
Case Name (If in litigation)
Named Insured
*
Defendant
Facts of Loss - Type of Loss
Additional Information (please note if any fatalities or serious injuries are involved.)
*
Assignment Instructions
Assignment Instructions
Obtain Signed Documents
Obtain Notarized Documents
Locate an Individual and Obtain Contact Information
Location Search / Skip Trace
Discovery Responses (Litigated File)
Obtain Photographs
Subpoena Service
Other:
Involved Party
Other: Involved Party Description
Involved Party's Name(s)
Involved Party's Email(s)
Involved Party's Phone #(s)
Involved Party's Address(es)
Additional Contact Information (Work, Family, etc.)
Vehicle/Property Type
Vehicle/Property Type
If Other, Describe Below.
Vehicle / Property Description
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