Name *

First Name

Last Name

Phone 1 *

(###)

###

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Alternate phone

(###)

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Address of fire *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Current residence address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Insurance adjuster phone *

(###)

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Name of the insured

First Name

Last Name

Please check all of the following: *

I understand that Rescue Laundry (part of The Laundry Spot) will work directly with my insurance adjuster. I give permission and authority to my insurance company to make payment(s) directly to The Laundry Spot.

I understand that The Laundry Spot will restore my clothes with a boosted ozone system. I understand there are no guarantees that the fire, smoke, water and/or mold damage will be reversed entirely.

I understand that all hangable items will be on hangers and other items such as socks and underwear will be folded and placed in clear bags.

I understand that all items given to The Laundry Spot will be washed, not dry cleaned. I will take items I want dry cleaned to the dry cleaners myself.

I understand that if I do not pick up my laundered clothes within one week of being notified of service completion, I will be charged a storage fee of $10/day after 1 week and $20/day after 2 weeks.