Customer's Claim & Affidavit (Spanish)

Damage to customer's property is included under a commercial general liability policy; this form describes items lost, seller, purchase date and depreciation. The claim amount is submitted with signature of customer and adjuster.
  PDF (61KB) Liability Property Forms Property & Casualty

Attending Physician's Report (Spanish)

A form which is filled out by the attending physician in order to qualify for medical benefits under an automobile insurance policy. (Spanish version of English form 3160F)
  PDF (80KB) Liability Spanish Workers' Compensation Forms Property & Casualty

Notice Of Plate Glass Loss

The notice of plate glass loss details the circumstances and description of loss. Included is an estimate for lowest replacement cost by a glazier.
  PDF (35KB) Property Forms Property & Casualty

Livestock Proof Of Loss

A livestock Proof of Loss and settlement document.
  PDF (50KB) Property Forms Property & Casualty

Minnesota WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Minnesota.
  PDF (0KB) Workers' Compensation Forms Property & Casualty

Connecticut WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Connecticut.
  PDF (0KB) Workers' Compensation Forms Property & Casualty

Massachusetts WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Massachusetts.
  PDF (0KB) Workers' Compensation Forms Property & Casualty

Kansas WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Kansas.
  PDF (0KB) Workers' Compensation Forms Property & Casualty

Employer Occupational Injury And Disease Report

Basic reporting form used by an employer to record an employee's injury or illness on the job.
  PDF (66KB) Workers' Compensation Forms Property & Casualty

Memorandum For Appraisal (Spanish)

Memorandum for Appraisal is used in property damage situations where insured and insurer disagree on actual cash value, and is binding on the parties as to the amount of loss.
  PDF (60KB) Auto Property Spanish Forms Property & Casualty

Notice Under Subrogation Rights (Spanish)

Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.
  PDF (31KB) Auto Liability Spanish Subrogation Forms Property & Casualty

PIP Wage & Salary Verification (Spanish)

This form is used to verify wage and salary information of a person who has applied for personl injury protection (PIP) benefits after an automobile accident.
  PDF (35KB) Liability Spanish Forms Property & Casualty

Vehicle Repair Order (Spanish)

Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.
  PDF (35KB) Auto Forms Property & Casualty

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