| Date of Report Submission: | 1/23/2023 |
| Submitters IP Address: | 172.70.114.118 |
Complaint Comments:
This is a test of the complaint form.
| Itemized Complaints | |
| Violation of Regulation PA Code Title 31, Ch. 62: | Yes |
| Non-Independent Appraisal: | Yes |
| Consumers Information | |||||
| Name: | **removed for privacy** | ||||
| Address: | **removed for privacy** | ||||
| City: | Paoli | State: | PA | Zip: | 19301 |
| Daytime Phone: | **removed for privacy** | Evening Phone: | **removed for privacy** | ||
| Repair Facility Information | |||||
| Repair Facility: | Sample Shop | ||||
| State Appraiser License: | 5555555 | ||||
| Shop Representative: | tom | Address: | |||
| City: | State: | Zip: | |||
| Phone: |
| Insurance Information | |||
| Insurance Company: | My Insurance | ||
| Claim Number: | 55555555 | ||
| Insurance Company Representative: | joe | Date of loss: | Jan 23 2023 | Appraiser License Number: | 33333333 |
| Insurance Company Phone: |
| Legislator Information | |||
| Consumer Legislative Representative: | Barrar, Stephen (R) District 160 | Consumer Senator: | Baker, Lisa (R) District 20 |
| Repair Facility Legislative Representative: | Benninghoff, Kerry A. (R) District 171 | Repair Facility Senator: | Baker, Lisa (R) District 20 |
END
PCTG Consumer Complaint Report Record ID#: -376574399