Your Information

• Your Name

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• Organization

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• Mailing Address

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• City

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• State

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• Zipcode

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• Phone

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• Email

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• Handling Attorney Name

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• Handling Attorney Email

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• Assistant Name

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• Assistant Email

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File Information

• Case Caption

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• Yes No Is this matter in litigation?

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• Name of party/parties you represent

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• Client scope of work

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• Property address(es)

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• Subcontractor involved

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• Preferred expert

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• Information/Description
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• Upload Pertinent Documents

Carrier Information

• Carrier Name

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• Carrier Claim Number

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• Carrier Claim Adjuster/Claim Professional

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Billing Information

• Contact Name

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• Billing Email

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