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The Nitsche Group
143 East Austin St.
Giddings, TX 78942
979.542.3666
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Main Office
143 East Austin St.
Giddings, TX 78942
979.542.3666
Commercial Property Claim
Your Contact Information
First Name
*
Last Name
*
Name of Insured
Policy Number
Company
*
Address
*
City
*
State
*
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ZIP
*
Phone
*
Email
*
Fax
Best Time to Contact
Loss Information
Date of Loss
*
January
February
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Month
*
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Day
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Year
Time of Loss
*
Location
*
Description of Occurrence
*
Authority Notification
Were the police called?
*
Yes
No
Case Number
*
Was the fire dept. called?
*
Yes
No
Case Number
*
Property Status
Is the property habitable?
Yes
No
If not, where are you staying/working?
Report Notification
Reported By
Reported Date
January
February
March
April
May
June
July
August
September
October
November
December
Month
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31
Day
2018
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2005
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2002
2001
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1963
1962
1961
1960
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1958
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1956
1955
1954
1953
1952
1951
1950
1949
Year
Additional Comments
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Main Office
143 East Austin St.
Giddings, TX 78942
979.542.3666