ADM Crop Risk Services - Notice of Loss

*	Indicate Type of Claim:	If Other Please Specify:
*	Insured's Name:
*	Insured's Telephone:
*	Agency Name:
*	Agent Name:
*	Agent Email Address:
*	Insured Address:
*	Insured City:
*	Insured State:
*	Insured County:
*	Storm Date:
*	Time:
*	Severity of Loss:
*	Crop Hail Policy Number:
*	Line Numbers from Policy Affected by Claim:
*	Type of 1st Crops Damaged:	Acres:
*	Type of 2nd Crops Damaged:	Acres:
*	Comments:	Enter comments here.
If HAIL should occur at harvest time, proceed with your harvest, but it is necessary to leave enough of the crop unharvested, such as the width of your combine head, 15ft. long at both ends of the field for the adjuster to fairly and accurately determine the loss. If a REPLANT situation or HARVEST SHATTER occurs because of hail, NOTIFY THE COMPANY BY PHONE (888-5ADMCRS) and submit this claim.