Notice Of Loss View Notice of Loss PDF A NOTICE OF LOSS must be submitted within 3 days after damage to crop. Notice to local agent is not sufficient. Send a notice direct to the office issuing the policy whose address is printed above. Any letter form of reporting a hail loss is acceptable. Any notice filed after 3 days may be subject to a surcharge penalty. This form supplied for your convenience.Name of Applicant* Address* City* Province*SelectAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonTelephone* Other Phone Email Power of Attorney Phone Today's Date* Month Day Year Please take notice that the following crops insured under the above policy were damaged by hail on:Date Month Day Year Time : Hours Minutes AM PM AM/PM Town Nearest the Loss Item No.* # of Acres* Grain* Quarter* Section* Township* Range* Meridian* Damage Type*LightMediumHeavyStage of growth when hailed* Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed Item No. # of Acres Grain Quarter Section Township Range Meridian Damage TypeLightMediumHeavyStage of growth when hailed I reside in the following quarter of section township range Note - I am aware that, according to the policy under which I am making claim, that if, for any reason, the insurer is not liable for loss, then I am liable for the expense incurred by the insurer for investigating said claim, and on demand, I promise to pay the insurer all such expense.THE INFORMATION BELOW IS REQUIRED UNDER THE PROVINCIAL INSURANCE ACTCompany Other hail insurance on same crops Amount per acre Company Other hail insurance on same crops Amount per acre Company Other hail insurance on same crops Amount per acre PhoneThis field is for validation purposes and should be left unchanged.
