Date:            

Name:           

Company:      

Reference:    

Address:        

City:                State:     Zip: 

Phone:                 FAX: 

Vehicle Information

Year:                       Make:          Model: 

Serial #:               Mileage:

Date of Loss:        Also provide list of optional equipment - if not shown on estimate sheet.

Vehicles that have been previously damaged or vehicles exceeding 100,000 miles do not meet the criteria for this report.  Be sure to send us a copy of the itemized repair estimate.  You may attach a scanned copy to an e-mail, FAX it to (301) 946-0489, or via mail to Reed Appraisers, 2313 Arcola Avenue, Wheaton, MD 20902.

Payment Advice

Insurance Companies:

We will invoice with completed report.  Please provide Claim Number.

Attorneys, Professional Organizations, & Fleets:

We accept company checks from professionals.

Other Interested Parties:

We accept Visa or Master Card from the General Public.

VISA    Master Card  Cardholder Name: 

                                     Card Number:          

                                     Expiration Date:     MO YR 

NOTE:  All information is confidential and will be released ONLY with the written consent of our client.

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