You may either download the appropriate Loss Notice Claim Form buy clicking on the links below or fill out the following on-line form and have one of our representatives call you. If you choose to download a claim form please print it and enter as much information as possible and either fax back (781-340-0628) and / or mail it to : A. E. Barnes Insurance Agency 141 Pleasant Street South Weymouth, MA 02190 Auto Crash Report General Liability Claim Report Property Loss Claim Report Workers Compensation Claim Report ProMutual First Notice of Loss
	Name:
	Address:
	City, State ZIP:
	Phone:
	Email:
	Date of Loss:

	Please check the Coverage/Policy Loss Report you wish to download:
	Auto
	Property
	Liability
	Worker’s Compensation
	Please contact me so I can report a claim. The best time to reach me is: a.m. p.m.