FAIR RENTAL EVALUATION REQUEST

Please complete the form below and a Temporary Housing Expert will contact you immediately. Make sure to let us know the best method to reach you. Thank you for choosing Relocation Consultants.

INSURANCE ADJUSTER INFORMATION

Contact Name

Company

Address

City

State

Zip Code

Best Method of Contact (you may choose more than one method)

 

Office Number

Pager Number

Fax Number

Cell Number

Email Address

 

Claim Information

Claim Number

Type of Loss

Length of Stay

Date of Loss

Value of Home

 

Homeowner Information

Number of Bedrooms

Number of Bathrooms

Fenced in yard Yes No

School District

 

Number of Adults

Number of Children

Pets Yes No

Description (how many, type, size, etc)

Damaged Residence Information

Address

City

State

Zip Code

Notes