Appraisalserviceofms.com -- ATS

Appraisalserviceofms.com	Appraisal Assignment Request
Vehicle

You can send us an assignment by filling in the form below.
Please provide as much information as possible.
Your request will be processed immediately.

Click to go to Property Web Form

Company Name:
Contact Name:	Adjuster Dispatcher Other
Phone:	(include area code)
E-mail:
Fax:	(include area code)
Sent Confirmation by:	E-mail Fax

Type of Assignment:
Claim Number:
Policy Number:
Deductible:	(put dollar amount only, 0 if none)
Date of Loss:	(mm/dd/yy)
Type of Loss:

Type of Claim:	Insured Claimant
Insured First/Last Name:
Address:
City:
State / Zip:
Home Phone:
Work Phone:
Claimant First/Last Name:
Address:
City:
State / Zip:
Home Phone:
Work Phone:

Vehicle Info

VIN:

Vehicle Location:

Location:
Address:
City:
State / Zip:
Phone:

Special Instructions: