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Claims

Name: SnapNsure
Address: 26895 Aliso Creek Rd suite b-439,, Aliso Viejo, CA, 92656, US
Telephone: +1 855-762-7467
Price range: $$

Home Claims

Self-Storage Proof of Loss Form

Please complete the required information below and an adjuster will be assigned to your claim and contact you shortly.
Name*
First Last
Coverage Amount: $
Monthly Premium: $
Address
Street Address Address Line 2 City State ZIP Code
Phone Number
Cell Number
Email
Date of Occurrence/Discovery*
MM slash DD slash YYYY
Date Loss Reported to Facility*
MM slash DD slash YYYY
Facility*
Date of Move In to Unit
MM slash DD slash YYYY
Facility Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Unit/Space #
Incident Reported by (Name)
First Last
Relationship to You
Legal Owner of Property At Time of Loss*
Last time at space/unit prior to loss
Do you have ANY other insurance covering property? (including homeowners)
- YES
- NO
Company
Policy Number
Loss reported to (Police/Sheriff Dept.)
- Yes
- No
Location
Case Number
What visible evidence of forcible entry did you see? (please provide photos)
Photo Upload
Max. file size: 10 MB.
Photo Upload
Max. file size: 10 MB.
Photo Upload
Max. file size: 10 MB.
In your own words, please describe in detail the events that led up to your loss. Be sure to include all pertinent facts about the loss.
Media Upload
Please upload any photos or videos you have below:
Photo Upload
Max. file size: 10 MB.
Photo Upload
Max. file size: 10 MB.
Photo Upload
Max. file size: 10 MB.
Supplementary Documents
Please upload any supplementary documents you have below:
File Upload
Max. file size: 10 MB.
File Upload
Max. file size: 10 MB.
File Upload
Max. file size: 10 MB.
Examples of Acceptable Documentation for Claims:
Receipts + (expands when clicked) Credit Card Receipts + Cancelled Checks + Photographs + Affidavits + Owner’s Manuals +
Claim List for Personal Property
Please detail items that you would like to claim below:
To add a new row to the claim list click the + at the end of each row.
Description of Item Quantity Place of Purchase (City,Store) Date of Purchase Cost Repair/Replacement Cost Sourc for R/R Cost Estimate

To add a new row to the claim list click the + at the end of each row.
In Signing this, I declare, under the penalty of perjury, that all of the information I have provided is true, correct and complete.
Type Name*
Signature*
Date*
MM slash DD slash YYYY

CA License #0L77661

Description of Item	Quantity	Place of Purchase (City,Store)	Date of Purchase	Cost	Repair/Replacement Cost	Sourc for R/R Cost Estimate

Claims

Self-Storage Proof of Loss Form

Please complete the required information below and an adjuster will be assigned to your claim and contact you shortly.

In your own words, please describe in detail the events that led up to your loss. Be sure to include all pertinent facts about the loss.

Media Upload

Supplementary Documents

Examples of Acceptable Documentation for Claims:

Claim List for Personal Property

In Signing this, I declare, under the penalty of perjury, that all of the information I have provided is true, correct and complete.