Adjusters Report/Certification

The Adjusters Report/Certification documents the insured property's location, date and type of loss, and summarizes replacement cost and A.C.V. for buildings, structural, contents and additional living expense, with line item detail.

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Adjuster's Loss Certification and Apportionment of Claim

This form is used to recommend to the insurer the amount of payment for a loss, and apportionment when a property is covered by two or more insurance companies.

NFIP Adjuster Certification Application (FEMA Form 086-0-21, 4/14)

This form is used to collect information from individuals seeking to become certified flood adjusters. NOTE: This form is currently under review at the Office of Management and Budget (OMB) and has expired effective April 30, 2017. However, OMB has authorized the continued use of the existing form, until the review process is complete.

Acknowledgement Of Assignment

Generic form used by independent adjusters to acknowledge receipt of a property insurance claim, and provide a preliminary report to the insurance company.

Notice of Loss (FEMA Form 086-0-11, 4/14)

This form is used by claims adjusters to document damages caused by flood-related hazards to structures covered by the National Flood Insurance Program.

Adjuster Status Report

Short form for reporting the current status of a claim. Typically used by an independent adjuster.

Alabama - Uniform Traffic Crash Report - Truck/Bus Supplemental Sheet (6/08)

The Alabama Uniform Traffic Accident Report and the Truck/Bus Supplemental sheet is to be completed when an accident meets both of the following criteria: (1) involves a truck with gross vehicle weight of 10,000 pounds or a Haz/Mat placard, or a vehicle designed to carry 9 or more people, and (2) results in at least one of the following: one or more fatalities, one or more persons injured and taken from the scene for medical attention, or one or more vehicles towed from the scene. Code legend is included.

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