NEW Property Claim Report

• Audit Title

• Conducted on

  Date

• Prepared by

• Location
  Address

Incident Information

• Location
  Address

• Date of Incident

• Asset Numbers

• Property Description

• Cause of Loss

• Location Photos

  Media

Vehicle/Mobile Equipment

• Vehicle Number

• Make

• Model

• Year

• Estimated Value

• Vehicle Photos

  Media

• Vehicle Number

• Make

• Model

• Year

• Estimated Value

• Vehicle Photos

  Media

Stock Information

• Yes

• Grain

• Feed

• Agronomy

• Fuel

• MAPS

• Stock Notes

BPP

• Yes

• BPP Notes

Report Prepared By

• Add signature

  Sign

Claim Information

• Date Reported to ABIS

• Claim #

• Adjuster Name

• Adjuster Contact Information