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Claim Submission
* Your Property Zip Code
* Property Name
* Person Submitting Claim
Resident
Property Management
* Resident First Name
* Resident Last Name
* Address or Apartment Number
* Date of Loss
* Phone Number
2nd Phone Number
* Email
* Cause of Loss
Select...
Fire
Water
Smoke
Wind
Hail
Lightning
Burglary
Other
Do you have a Fire Report?
Yes
No
Do you have a Police Report?
Yes
No
* Please Enter a Brief Description of Loss
This policy contains a $500 Deductible for Losses and $1000 Burglary.
Are your Losses Over the Deductible?
[
More Details
]
Yes
No
Please attach the following documents (if applicable)
Pictures of the damaged items, List of items lost with replacement value, Fire Report, Police Report (Required for Burglary). Uploaded files must be in one of the following formats: pdf, jpg, tif, docx
NOTE:
You can select multiple files by holding the "Ctrl" key and clicking the files in the selection window.