Immediately Assign New Losses Directly Through our Website!
To quickly and efficiently assign a new loss simply complete the form below. A Booth & Associates representative will be in touch with you shortly. Thank you for engaging us to solve your Commercial Salvage concerns.
Adjusters / Risk Managers: - To submit new loss information to us, simply
   (1) Key in loss and contact information in the form below, and . . .
   (2) Click the "Submit Loss Information" button at the bottom of the form.

(  *  denotes required fields )

Insured: *
Insured Phone: *
Insured Address: 
Insured City:
Insured State:
Insured Zip:
Insured E-mail:
Contact at Loss: *
Adjuster/Risk Mgr: *
Adjuster/Mgr Phone: *
Adjuster/Mgr Fax:
Adjuster/Mgr Co.: *
Adjuster/Mgr Address:
Adjuster/Mgr E-mail: *
Adjuster/Mgr File #:
Insurance Company:
Policy #:
Claim #:
Date of Loss: *
Type of Stock: *
Type of Damage: *
$ Value - Retail:
$ Value - Cost:
Assignment
Instructions:




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