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PJ Disclosure and Contract 3.doc 2026
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- Click ‘Get Form’ to open the PJ Disclosure and Contract 3.doc in the editor.
- Begin by entering the Public Insurance Adjuster’s name, Paul Dix, along with his address, license number, telephone, and email in the designated fields.
- In the section labeled 'Insured', fill in your name and details regarding the loss you are claiming. Specify the date of occurrence and provide a description of the peril.
- Complete the insurer's information including their name, policy number, and claim number as required.
- Indicate your agreement on payment terms by filling in the percentage fee for services rendered after signing this contract. Don’t forget to initial where indicated.
- Sign and date the contract at the bottom to finalize your agreement with Paul Dix Adjusters.
- Review the Notice of Cancellation section carefully. If you wish to cancel within three business days, ensure you follow the outlined procedure for cancellation.
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