Request Form : Rush Appraisal Service : Fast, Dependable Appraisal Services : Lubbock, Texas

Rush Appraisal Service

Please complete this form to request an appraisal.

Please Attach Request/Loss Notice Form Or complete the following:
Adjuster's Name:
Phone:
Fax:
Adjuster's E-Mail:
Address Line 1:
Address Line 2:
City:
State:
Zip:
Claim NO.:
Policy NO.:
Date Of Loss:
Insured:
Claimant:
Owner Address Line 1:
Owner Address Line 2:
City:
State:
Zip:
Home Phone:
Work Phone:
Cell Phone:
Other:
Veh. Year:
Veh. Make:
Veh. Model:
Veh. Color:
Veh. License:
VIN:
COLL COMP PD
Deductible:
Damages:
Location:
Special Instructions:
Total Loss Requirements
CCC Form:	Attached To File Called In For Evaluation ID NO.:
Auto Source Form:	Attached To File Called In For Evaluation ID NO.:
Salvage Bids:	Yes No
Total Loss Special Instructions:
Move To Salvage Pool: (Only With Owner's OK)	Yes No
If yes, provide salvage pool information and salvage codes for moving salvage:
File Uploads: (Please Attach Important Files)

Choose Rush Appraisal Service for fast, dependable insurance appraisals performed by experienced, independent appraisers.

Phone: 806-793-2002
Fax: 806-793-7968
rushapp@rushappraisal.net
3309 67th Street
Suite 28
Lubbock, Texas 79413