SOS™ Claim Assignment

Please fill out the following information as best you can. Then click the Submit Request button at the bottom of this form.

If you do not receive an email confirmation that your assignment was received, please email Bill Stickler, bill.stickler@soscontents.com.

Adjuster Information

First Name		Last Name
Company		Location
Street Address		City
State		Zip-Code
Work Phone	Invalid format.	Extension
Email	A value is required.Invalid format.	Fax Number	Invalid format.

Save adjuster settings

Insured Information

First Name		Last Name
Street Address		City
State		Zip-Code
Home Phone	Invalid format.	Work Phone	Invalid format.
Cell Phone	Invalid format.	Fax	Invalid format.
Email	Invalid format.

Other Contact Information (Atty., PA, Other Family Member)

Claim Information

Claim Number		Date of Loss	Follow this format: MM/DD/YY
Deductible ($)		UPP Policy Limit ($)

Peril Type
Coverage	RC ACV

Additional Vendor Support - If Applicable
Please provide the name and phone number of the drycleaner, pack out company, or restoration company that has been assigned. Please identify a contact person.

Loss Site Information

Other Information

Attachments

Ways to Assign a Claim

LiveChat

JEM™ Chat

IW Assignment Form

SOS™ Assignment Form

SIU Assignment Form

Fax and Email

Call Us: 800.343.9619