New Assignment Form

New Assignment

After you fill out this assignment request, we will begin processing your request immediately Monday thru Friday 8am-5pm/cst. Assignments submitted after 5pm on Friday will be processed on the next business day. If you have any questions please reach out directly to us. Contact us at (256) 500-0225 or admin@vehiclespecialtyappraisals.com
Your Name*

First NameLast NameTitle
Phone Number*
Email*
example@example.com
Assignment Type*
Assignment Date *

MonthDayYear
Company*
Claim Number*
Date of Loss*

MonthDayYear
Company Address (If not already on file)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vehicle Location*

Business/Contact Name
Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Vehicle Information (Enter UNK if Unknown)*
Additional Comments
Should be Empty: