Expert New Case Submission Rappaport Consulting LLC Step 1 of 12 8% Attorney or Claim Representative name*Company Name* Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Number* Email* Claim or File Number* Case Name* Client or Insured Name* Date of Loss or Incident* MM slash DD slash YYYY Time of Loss : Hours Minutes AM PM AM/PM Address of Loss or Incident* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Other Email Other Phone Number Additional Information* Contact Information (310) 806-8057 robert@rappaportconsulting.com 3905 State Street, Suite 7199, Santa Barbara, CA 93105
