3748 Oakton Street

Skokie, IL 60076

1-877-447-6646

(1-877-4IRMOINS)

 

 

Irmo Insurance Agency, Inc.

Licensed in Illinois, Indiana,

Kentucky,  New York

Pennsylvania & Wisconsin

 
 
 
 
 
 
 
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Need to report a property loss?  Please complete the form below and click submit to send it to Irmo Insurance Agency, Inc. If you have any questions while completing this form, please email us at office@irmoinsurance.com or call us at 847-677-0505.

 

Property Loss Notice

No coverage bound until you are contacted by one of our representatives 

 General Information
 Name  
 Street Address  
 Street Address  
 City, State, Zip  
 Phone Number(s)   Home Work
 Email  
 Policy Number  
 Insured Name, if different  
 Loss Details
 Date of loss  
 Location of loss  
 Type of loss  
 Estimated total value of loss  
 Reported to Police or Fire Dept?  
      If yes, name of Dept  
      If yes, report number  
 Description of loss and/or damage

 

 

 
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