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Email
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Your answer
Full Name (As it appears on your license)
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Your answer
Claims Preference
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Daily Claims
CAT Claims
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Role: Field Adjuster/Desk Adjuster/QA Reviewer (Check all that apply)
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Field Adjuster
Centralized Desk Adjuster (In Office)
Remote Desk Adjuster
QA Reviewer
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Phone
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Do you agree to receive SMS Text Messaging
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Software Experience
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Xactimate
Symbility
Xactanalysis
Other:
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Xactnet Address (Please confirm in your Xactimate account)
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Residential Property Adjusting Experience (Years)
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Your answer
Commercial Property Adjusting Experience (Years)
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Your answer
Appraisal/Mediation Experience (Years)
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Your answer
PA/Attorney Represented Claims (Years)
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Casualty Claims Experience (Years)
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Auto/Truck Appraisal Experience (Years)
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QA Reviewer Experience (Years)
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Your answer
Workers Compensation Experience (Years)
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NFIP Certified
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Yes
No
TWIA Certified
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Yes
No
California Earthquake Certified
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Yes
No
NCJUA Storm Readiness Class
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Yes
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Home State License (List State, Number, Expiration Date)
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Additional State Licenses (List State, Number, Expiration Date)
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NPN (National Producer Number)
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Address Street 1
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Address Street 2
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Address City
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Address State
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Address Zip
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Additional Qualifications: Tell us about yourself
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