Quality Independant Appraisals
185 King George Road, PO Box 24054
Brantford, ON, Canada N3R 7X3
Phone: 519-754-0512 Fax: 519-754-0833
Assignment Sheet
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Rite-Way Appraisals Inc.
Quality Inependent Appraisals
185 King George Road, PO Box #24054
Brantford, ON N3R 7X3
Insurance Co:
Your File #:
Adjuster:
Phone #:
Fax #:
Address:
Postal Code:
City:
Coll.:
Comp.:
Unknown:
Date of Loss:
Deductible:
43R:
Yes
No
Insured pays GST:
Yes
No
Insured:
Phone #:
Bus. #:
Address:
City:
Postal Code:
Year:
Make:
Model:
License #:
Vin:
Area of Damage:
Shop:
Location:
Address:
Vehicle at Shop:
Yes
No
Remarks