Restoration Evaluation Form

Restoration Evaluation Form

In order to most accurately assess the possibilities of restoration on any claims that can’t be fully restored or
are considered unsalvageable, please complete the following form and return it to The Madame Paulette
Organization, via email, at aigclaims@madamepaulette.com









Please specify the type of item that was damaged:

*

Please specify the type of damage:

*

Please attach a digital photo(s) for each item