Supplemental Report
The supplemental report contains information not obtained at the origination of the report.
 | Fields that are required contain an * and fields that are recommended contain a +. |
The following table contains the required and recommended fields for the supplemental report.
| Field | Req / Rec |
|---|---|
| Adjuster ID | Required |
| Account | Required |
| Claim Number | Required |
| Incident Date | Required |
| Street Address Number or Name | Recommended |
| Cross Street Name | Recommended |
| City | Recommended |
| State or Province | Required |
| Agency Name | Required |
| Agency Type | Required |
| Report Number | Recommended |
| Last Name | Required |