Resource Management Associates, Inc.
109 South Front Street, Suite 210
Marquette, MI 49855

-Refer an Assignment-

Client Identification
Company Name
Email address
Address 1
Address 2
City
State
Zip
Phone
Fax
Case Manager
Information on Subject of Investigation
Subject Name
Address 1
Address 2
City
State
Zip
Phone
Date of Birth
Employer/Insured
Insured Contact
Contact Phone
Phys. Limitation/Nature of Injury
Date of Loss/Injury
Job Description at Time of Injury
Is Subject Represented by an Attorney?
Trial Date
Spouse/Live-In Partner
Dependents
Physical Description
Is a Photo Available?
Vehicles
Financial Authority
Per Hour
Per Mile
Per Day
Additional Instructions and Information
  

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