Appraisal Request Form

Law Firm Information
Law Firm Name (Company You Represent)*
Law Firm Contact (Your Name)*
First Last
Law Firm Contact Email (Your Email)*
Law Firm Contact Phone (Your Phone)*
Attorney Information
Name of Attorney Handling This File*
Email of Attorney Handling This File*
Phone Number of Attorney Handling This File*
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*
Date of Loss*
MM slash DD slash YYYY
Date of Loss*
MM slash DD slash YYYY
Date of Loss*
MM slash DD slash YYYY
Date of Loss*
MM slash DD slash YYYY
Insurance Carrier*
Policy Number
Claim Number
Did You File A CRN?*
- Yes
- No
Date of its Filing
MM slash DD slash YYYY
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 Upload. Please make sure to include below the declaration page in effect when the loss occurred, as well as all correspondence from the Insurance Company. Additionally, documents may be emailed to info@flbestpa.com
Documents Upload. Please make sure to include below the declaration page in effect when the loss occurred, as well as all correspondence from the Insurance Company. Additionally, documents may be emailed to info@flbestpa.com.
Drop files here or

Max. file size: 128 MB.
Additional Notes

Law Firm Information