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Litigation Support Assignment Request Form
Litigation Support Assignment Request Form
appraisalsupport
2020-10-16T18:18:22+00:00
Law Firm Information
Law Firm Name (Company You Represent)
Name of Attorney handling this file
*
First
Last
Email of Attorney handling this file
Phone Number of Attorney handling this file
*
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 Email
Homeowner Phone
Physical Address of the property to be inspected
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Peril
*
Hurricane
Water
Roof Leak
Wind
Hail
Lightning
Fire
A/C Leak
Pipe Break
Sewer Backup
Other
Date of Loss
MM slash DD slash YYYY
Notes
Documents Uploads
Max. file size: 128 MB.
Please make sure to include below the declaration page in effect when the loss occurred.
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