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Vehicle Assignments

Your Info
Date Claim #
    Your Name: ..... Adjuster
Company Telephone #
Your Email Address Fax #

Vehicle Info
Owner Miles
Year Color
Make Doors
Model Primary Damage
VIN # Location Of Vehicle

Pool Inventory
Radio

Missing
Factory
Cass
CD

 AirBags
Driver's Side Passenger's Side
N/A
Good
Deployed		 N/A
Good
Deployed
Wheels

Steel
Alloy

 Keys

Yes
No
Missing Items Comments

 

Thank you for your submission!

***Please note***
A copy of each vehicle assignment that you submit via this form will be
emailed to you to confirm your entry. If you do not receive this email within
24 hours, please contact us at: plautopool@sbcglobal.net Thank you.