Diminished Value Investigation Approval Form
Please fill out the details to authorize the investigation.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Year
*
Make
*
Model
*
Email Address
*
example@example.com
Current Miles
*
Have you received an offer?
*
Yes
No
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
SC only at-fault Insurance Company
*
Is your insurance paying for the claim?
*
Your Insurance
Other Insurance
Insurance Company Name
*
Claim Number
*
Type a question
*
Approved $495 DV Report
I Understand $150 is not refundable
I understand Beaufort County auto appraisal cannot guarantee payment from the insurance company
I understand the report is intended to provide a professional opinion of the vehicles diminish value.
I have not received a DV payment from the insurance company or cashed one.
As far as I know, my car has not been involved in another accident prior to the current one.
Signature
*
DateTime
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