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Armed Forces Americas
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D.B.A., INC. LLC
Number of Employees doing business under this name
This is a daily claims handling operation. If you are applying for an outside adjusting position, you must commit to being available in your respective territory and surrounding area on a daily basis. We handle multiple companies with varying degrees of complexity and you must be willing to handle all assignments sent to you.
Home Telephone
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Business Telephone
Cellular Phone
Are you 18 years of age or older?
Yes
No
If hired, Federal Law requires that you furnish documentation establishing your identity and eligibility to work in the United States:
Do you have United Sates citizenship or authorization from the Immigration & Naturalization Service to work in the U.S.?
Yes
No
Have you ever been convicted, pled guilty, nolo contendere (no contest), or recived deferred adjudication for violation of any law other than minor traffic violations?
Yes
No
If yes, please explain:
Are you willing to work holidays and weekends if necessary?
Yes
No
Please list your last two positions starting with present or recent employer. Complete even if resume provided.
Company 1:
Company Name
Address
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
Dates Employed (Month & Year)
Salary Starting & Ending
Job Title and Description of Duties:
Reason for Leaving:
Company 2:
Company Name
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone
Dates Employed (Month & Year)
Salary Starting & Ending
Job Title and Description of Duties
Reason for leaving
May we contact the above listed employers?
Yes
No
If not, please indicate the employers you do not wish us to contact:
Education
High School
Name and Location of School
Course of study
Years completed
Did you graduate?
or diploma
from/to
College
Name and Location of School
Course of study
Years completed
Did you graduate?
or diploma
from/to
Technical / Trade Schoo
Name and Location of School
Course of study
Years completed
Did you graduate?
or diploma
from/to
Other
Name and Location of School
Course of study
Years completed
Did you graduate?
or diploma
from/to
Please list languages, other than English, you speak fluently:
Professional licenses or designations you currently hold:
Summarize special skills and qualifications acquired from employment or other experience.
Typing WPM:
Skills
PC Operating Systems
No Experience
Novice User
Average User
Highly Skilled
MS Word
No Experience
Novice User
Average User
Highly Skilled
MS Excel
No Experience
Novice User
Average User
Highly Skilled
PC Operating Systems
No Experience
Novice User
Average User
Highly Skilled
Adobe Acrobat
No Experience
Novice User
Average User
Highly Skilled
Xactimate
No Experience
Novice User
Average User
Highly Skilled
Other
No Experience
Novice User
Average User
Highly Skilled
Please list other software you have experience with:
This section for Adjuster Applicants Only
Have you had any building construction or carpentry experience?
Yes
No
If yes, in what capacity?
Do you presently have a valid adjuster license?
Yes
No
Do you presently have a valid adjuster license?
How long have you been licensed?
Licensed State?
Adjuster License #:
Date of Expiration:
Please select the years of experience you have in each item listed below:
Boat Physical Damage
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Earthquake
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Boat Physical Damage
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Flood
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Fire
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Inland/Ocean Marine
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General Liability
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Fine Arts
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Environmental
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Hazardous Materials
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Mobile Home
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Casualty
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Property: Commercial
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Dwelling
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ALE
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Liability
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Construction Defects
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Consent
I hereby certify my answers to all questions on this application are true and complete.
I understand that any falsified or misrepresented statements on this application shall disqualify me from the hiring process or if hired, will be grounds for dismissal. I authorize Cross Claims Services, Inc.(CCSI), to investigate and verify all statements and information provided. I hereby release from liability CCSI and its representatives for seeking, gathering, and using such information and all other persons, corporations, and organizations from furnishing such information. I understand CCSI may require a drug screen, background check, and credit report as part of their hiring procedure. If hired, I further agree to obey the policies and procedures of CCSI.
Email
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