Adjuster Application and Onboarding
Apply to join our independent claims adjusting team. Please complete all fields and upload required documents.
Full Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Deployment Radius (miles)
Are you available for CAT (Catastrophe) deployments?
Yes
No
Years of Adjusting Experience
*
Lines Handled
Property
Auto
Casualty
Flood
Liability
Other
Estimating Software Used
Xactimate
Symbility
Simsol
Other
Certifications
States Licensed & License Numbers
Upload Resume
Upload a File
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Upload Adjuster License
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Upload Certifications
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Upload W-9
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Upload E&O Insurance
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Direct Deposit Information
Please provide the bank details for your payout deposits.
Bank Name
*
Account Type
*
Checking
Savings
Account Holder Name
*
Routing Number
*
Account Number
*
Confirm Account Number
*
Upload Voided Check
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of
Signature
Submit Application
Submit Application
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