This is the "html" version of the Property Loss Notice that the Insured completes. The Insured and Policy Information automatically prefill from the customer database. Limits and coverages have been purposely omitted to eliminate any confusion by the customer. Every Loss Notice also includes an attachment permitting 55 lines of additional free-form information.

To submit forms to the Agency, the customer simply presses the Continue button. They also have the option to enter an additional e-mail address to "cc" the form to another interested party. All forms received by the Agency or additional parties are in a "PDF" format.

Click here to view a screen shot of the Property Loss Notice in "PDF Format.