R.E. Pratt and Company: Online Claims Assignment Form Fill out this form and click the "Submit Claim" button at the bottom.

Check all appropriate processing for this claim assignment: Full assignment Photos required Appraise collision Appraise property damage Secure official reports Scene Investigation Secure recorded statements Evaluate bodily injury/business interruption Cause & origin investigation Obtain expert PILR Ins. to value worksheet

Person Assigning Claim Name (required): Email (required): Company Assigning Claim: Phone #: Claim #: Insured: Policy #: Date of Loss: Insured's Address: Insured's Telephone: Claimant's Name and Address: Claimant's Telephone: Loss Location:        Closest N.C. city ==>        _Select a city AberdeenAhoskieAlamanceAlbemarleAlexander MillsAllianceAndrewsAngierAnsonvilleApexArapahoeArchdaleArlingtonAsheboroAshevilleAskewvilleAtkinsonAtlantic BeachAulanderAuroraAutryvilleAydenBadinBaileyBakersvilleBanner ElkBathBayboroBear GrassBeaufortBeech MountainBelhavenBellwoodBelmontBelvilleBensonBessemer CityBethaniaBethelBeulavilleBiltmore ForestBiscoeBlack CreekBlack MountainBladenboroBlowing RockBoiling Spring LakesBoiling SpringsBoliviaBoltonBooneBoonvilleBosticBrevardBridgetonBroadwayBrookfordBrunswickBryson CityBunnBurgawBurlingtonBurnsvilleCalabashCalypsoCameronCandorCantonCape CarteretCarolina BeachCarrboroCarthageCaryCasarCastaliaCaswell BeachCatawbaCedar PointCentervilleCerro GordoChadbournChapel HillCharlotteCherryvilleChimney Rock VillageChina GroveChocowinityClaremontClarktonClaytonClemmonsClevelandClintonClydeCoatsCofieldColerainColumbiaColumbusComoConcordConetoeConnelly SpringsConoverConwayCooleemeeCorneliusCove CityCramertonCreedmoorCreswellCrossnoreDallasDanburyDavidsonDentonDillsboroDobbins HeightsDobsonDortchesDoverDrexelDublinDunnDurhamEarlEast ArcadiaEast BendEast LaurinburgEast SpencerEdenEdentonElizabeth CityElizabethtownElk ParkElkinEllenboroEllerbeElm CityElon CollegeEmerald IsleEnfieldErwinEurekaEverettsFair BluffFairmontFaisonFaithFalconFalklandFallstonFarmvilleFayettevilleFletcherForest CityFountainFour OaksFoxfire VillageFranklinFranklintonFranklinvilleFremontFuquay-VarinaGamewellGarlandGarnerGarysburgGastonGastoniaGatesvilleGibsonGibsonvilleGlen AlpineGodwinGold HillGold PointGoldsboroGoldstonGrahamGrandfather VillageGranite FallsGranite QuarryGreen LevelGreeneversGreensboroGreenvilleGriftonGrimeslandGroverHalifaxHamiltonHamletHarmonyHarrellsHarrellsvilleHarrisburgHassellHavelockHaw RiverHayesvilleHendersonHendersonvilleHertfordHickoryHigh PointHigh ShoalsHighlandsHildebranHillsboroughHobgoodHoffmanHolden BeachHolly RidgeHolly SpringsHookertonHope MillsHot SpringsHudsonHuntersvilleIndian BeachIndian TrailJacksonJacksonvilleJamestownJamesvilleJeffersonJonesvilleKannapolisKelfordKenansvilleKenlyKernersvilleKill Devil HillsKingKings MountainKingstownKinstonKittrellKitty HawkKnightdaleKure BeachLa GrangeLake LureLake ParkLake WaccamawLandisLansingLaskerLattimoreLaurel ParkLaurinburgLawndaleLeggettLelandLenoirLewiston-WoodvilleLewisvilleLexingtonLibertyLilesvilleLillingtonLincolntonLindenLittletonLocustLong BeachLong ViewLouisburgLove ValleyLowellLucamaLumber BridgeLumbertonMacclesfieldMaconMadisonMaggie ValleyMagnoliaMaidenManteoMariettaMarionMars HillMarshallMarshvilleMatthewsMaxtonMayodanMaysvilleMcadenvilleMcdonaldMcfarlanMebaneMesicMicroMiddleburgMiddlesexMiltonMinnesott BeachMint HillMocksvilleMomeyerMonroeMontreatMooresboroMooresvilleMorehead CityMorgantonMorrisvilleMorvenMount AiryMount GileadMount HollyMount OliveMount PleasantMurfreesboroMurphyNags HeadNashvilleNavassaNew BernNew LondonNewlandNewportNewtonNewton GroveNorlinaNormanNorth Topsail BeachNorth WilkesboroNorthwestNorwoodOak CityOakboroOcean Isle BeachOld FortOrientalOrrumOxfordPantegoParktonParmelePatterson SpringsPeachlandPembrokePikevillePilot MountainPine Knoll ShoresPine LevelPinebluffPinehurstPinetopsPinevillePink HillPittsboroPlymouthPolktonPolkvillePollocksvillePowellsvillePrincetonPrincevilleProctorvilleRaefordRaleighRamseurRandlemanRanloRaynhamRed OakRed SpringsReidsvilleRennertRhodhissRich SquareRichfieldRichlandsRiver BendRoanoke RapidsRobbinsRobbinsvilleRobersonvilleRockinghamRockwellRocky MountRolesvilleRondaRoperRose HillRoseboroRosmanRowlandRoxboroRoxobelRural HallRuthRutherford CollegeRutherfordtonSaint HelenaSaint PaulsSalemburgSalisburySaludaSandy CreekSandyfieldSanfordSanteetlahSaratogaSawmillsScotland NeckSeaboardSeagroveSelmaSeven DevilsSeven SpringsSevernShallotteSharpsburgShelbySiler CitySimpsonSimsSmithfieldSnow HillSouthern PinesSouthern ShoresSouthportSpartaSpeedSpencerSpencer MountainSpindaleSpring HopeSpring LakeSpruce PineStaleyStallingsStanfieldStanleyStantonsburgStarStatesvilleStedmanStemStokesdaleStonevilleStonewallStovallSugar MountainSunset BeachSurf CitySwansboroSylvaTabor CityTar HeelTarboroTaylorsvilleTaylortownTeacheyThomasvilleTobaccovilleTopsail BeachTrent WoodsTrentonTroutmanTroyTryonTurkeyUninc.ValdeseVanceboroVandemereVarnamtownVassWacoWadeWadesboroWagramWake ForestWallaceWalnut CoveWalnut CreekWalstonburgWarrentonWarsawWashingtonWashington ParkWathaWaxhawWaynesvilleWeavervilleWebsterWeldonWendellWest JeffersonWhispering PinesWhitakersWhite LakeWhitevilleWilkesboroWilliamstonWilmingtonWilsonWindsorWinfallWingateWinston-SalemWintervilleWintonWoodfinWoodlandWrightsville BeachYadkinvilleYanceyvilleYaupon BeachYoungsvilleZebulon           OR SELECT         N.C. county ==>        _Select a county Alamance Alexander Alleghany Anson Ashe Avery Beaufort Bertie Bladen Brunswick Buncombe Burke Cabarrus Caldwell Camden Carteret Caswell Catawba Chatham Cherokee Chowan Clay Cleveland Columbus Craven Cumberland Currituck Dare Davidson Davie Duplin Durham Edgecombe Forsyth Franklin Gaston Gates Graham Granville Greene Guilford Halifax Harnett Haywood Henderson Hertford Hoke Iredell Jackson Johnston Jones Lee Lenoir Lincoln Macon Madison Martin McDowell Mecklenburg Mitchell Montgomery Moore Nash New Hanover Northampton Onslow Orange Pamlico Pasquotank Pender Perquimans Person Pitt Polk Porquimans Randolph Richmond Robeson Rockingham Rowan Rutherford Sampson Scotland Stanly Stokes Surry Swain Transylvania Tyrrell Union Vance Wake Warren Washington Watauga Wayne Wilkes Wilson Yadkin Yancey Loss Location (more detail if necessary): Local Authorities (police, fire department, etc.): Description of Loss: Handling Instructions: