Report A Claim
PLEASE NOTE:
Any changes requested on this website are NOT official until you receive written confirmation from The Hoxton Agency, Inc.
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Please be sure to download this form to your computer before you start filling it out. If you fill it out from your Internet browser window, the data may not be saved.
After you have completed the form in its entirety, please print and sign the document before faxing it to our office. If you choose to submit the form via e-mail, you must have the capability of producing an authentic electronic signature, as all forms require an original signature. Fax the forms to: (304)876-3530.