Appraisal Request Form

Law Firm Information
Law Firm Name (Company You Represent)*
Law Firm Contact (Your Name)*
First Last
Contact Email (Your Email)*
Contact Phone (Your Phone)*
Claim Information
Name of the Homeowner*
First Middle Last
Homeowner Phone
Homeowner's Email
Physical Address of the property to be inspected*
Street Address Address Line 2 City State ZIP Code
Peril
Insurance Carrier
Policy Number
Claim Number
Date of Loss
Date Format: MM slash DD slash YYYY
Notes
Opposing Appraiser's Info
Opposing Appraiser's Name*
First Last
Opposing Appraiser's Phone*
Opposing Appraiser's Email*
Other Info
Who should we bill for our appraisal services ?*
- Your Law Firm
- The Client listed above
Documents Uploads
Please make sure to include below the declaration page in effect when the loss occurred.
Additional Notes
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Law Firm Information