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(510) 785-0102

CSLB #889643

Submit Your Claim Online

California Emergency Services realizes your time is valuable. To make our claims process more convenient for you we have started this online claim form. Please fill out the following information in its entirety and we will respond to your request as soon as possible.

Items marked with a * are required.
   
*Date of Loss: , 20
*You Are The:
*Your Name:
*Loss Site Address:
*City:
*State:
*Zip:
*Phone:
*Email:
Claim Details: Please describe the situation
 
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*Additional information may be required to complete your claim

 

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