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Toll-Free:
(800) 952-7693
Panhandle Area:
(850) 807-0123
Treasure Coast Area:
(772) 217-6161
Palm Beach County:
(561) 715-8986
Dade & Broward County:
(954) 414-9557
Greater Fort Myers Area:
(239) 580-6482
Greater Jacksonville Area:
(904) 512-1326
Greater Orlando Area:
(407) 476-4949
Greater Tampa Bay Area:
(813) 895-3149
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(800) 952-7693
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(800) 952-7693
Services
Denied and Underpaid Claims
Hurricane Damage
Water Damage
Storm Damage
Smoke and Fire Damage
Roof Leak Damage
Mold Damage
Business Interruption
Dropped or Falling Objects
Sinkholes
Litigation Support & Appraisal Services
Locations
Boca Raton Area
Fort Lauderdale Area
Fort Myers Area
Orlando Area
Tampa Area
Jacksonville Area
Tallahassee Area
West Palm Beach Area
Parkland Area
Reviews
Local Reviews
Notes from Happy Customers
About
Our Adjusters
Our Process
Did You Know?
Blog
FAQ
Case Studies
Case Studies
Gallery
Claim Registration
FEMA Letter
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FEMA Letter
FEMA Letter Of Representation
"
(Required by FEMA)
" indicates required fields
Insured Name:
(Required by FEMA)
Additional Insured Name:
leave blank if none
Email:
(Required by FEMA)
Loss Address:
(Required by FEMA)
City, State and Zip Code MUST be Provided
Mailing Address:
(Required by FEMA)
City, State and Zip Code MUST be Provided
Date of Birth:
(Required by FEMA)
MM slash DD slash YYYY
Place of Birth:
(Required by FEMA)
Insurance Company:
(Required by FEMA)
Policy Number:
(Required by FEMA)
Authorized Representative:
(Required by FEMA)
County of Signature:
(Required by FEMA)
Date of Loss:
(Required by FEMA)
MM slash DD slash YYYY
To whom it may concern,
I expressly grant permission to FEMA to release my records to these third-party representatives.
“I declare under penalty of perjury that the foregoing is true and correct” Executed on day of , 2022 (Pursuant to 28 U.S.C S 1746).
Executed on Month
(Required by FEMA)
January
February
March
April
May
June
July
August
September
October
November
December
Executed on Day
(Required by FEMA)
1
2
3
4
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14
15
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20
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22
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31
Executed on Year
(Required by FEMA)
Insured's Name
(Required by FEMA)
Signature
(Required by FEMA)
Additional Insured's Name
Additional Signature
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