Knew Line  
The family of companies for the insurance and legal professional
(941) 388-7886

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on-line assignment forms
Please use the pull down bar on the subject line and select the service that best fits your request.

Fill out the form with as much information as you have right now. A investigator will contact you shortly to verify and or go over your assignment with you.

All contact with Knew Line is always confidential and between us and yourself only.


Subject: *
E-mail Address: *
Your name & company name
Company mailing address
Your direct phone number
Your file number
Date of accident
Claimants name
Claimants address
Claimants date of birth
Claimants social security #
Injured body part (s)
Is claimant married, spouse name
Claimant have children
If this is for a sweep you can stop here if you wish.
Insured company name and address
Insured contact person
Insured phone number
Claimants date of hire
Accident location
Time of accident
Description of claimant
Witnesss names, if known
Transcription of recorded statement
Need forms signed by claimant
Insureds statement needed Yes
No
special instructions
Attach a File:

* Required
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