Reed Appraisers Assignment Form

2313 Arcola Avenue, Wheaton, MD 20902

D.C. & Maryland                                             301-946-6116

Northern Virginia                                             703-824-1718

Client: ________________________________________________________________

Address: ______________________________________________________________

City: _____________________________   State:____________   Zip: ____________

Phone: ______________________ Ext __________   Fax: _______________________

Assigned By: ___________________________________________________________

Send To: ______________________________________________________________

Claim Number: ________________________________ Loss Date: ________________

ÿ Insured: _______________________________________________________________

ÿ Claimant: ______________________________________________________________

 Address: _______________________________________________________________

City: _____________________________   State: ______________   Zip: ___________

Phone: (H)__________________   (W)__________________   (C)_________________

Year: ___________ Make: _____________________ Model: _____________________

Serial # __ __ __ __ __ __ __ __   Tag: __________________   Color: _______________

                  (Last 8 Digits of VIN)

Impact Area: ____________________________________________________________

Location of Vehicle: ______________________________________________________

Shop Estimates: _________________________________________________________

Comments / Instructions: ___________________________________________________

_______________________________________________________________________

_______________________________________________________________________

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