SUBMIT ASSIGNMENT



This form is for insurance company adjusters and agents only.
If you have a claim that you would like our company to inspect please fill in the information into the required fields below.



NEW ASSIGNMENT



Required Fields are *

WILL NOT SEND WITHOUT
REQUIRED FIELD INFORMATION



CLIENT INFORMATION



















CUSTOMER & VEHICLE INFORMATION








































send >


Thank you for
your submission.

You will receive an email
confirmation once
our office receives your
assignment request.

HALLER APPRAISAL
SERVICE, INC.




PHONE: 248.477.3400
FAX: 248.473.9830
EMAIL: HOME.OFFICE@HALLERAPPRAISAL.COM

HOURS OF OPERATION:
MONDAY-FRIDAY 8:30AM-4:30PM