CASE RACE COUNT ME IN!

1

Is this being completed because you just had a NEW ASSURITY CASE TRANSMITTED with over $2,999 in AP written?This must be a "yes" to continue. Verification will be conducted at the end of the contest period.

YESNO

2

Transmittal date:* This field is required.Please type in the date the TRANSMITTAL was sent in (Not the FECN)

Date

3

Partner getting credit for Case Race Credit:* This field is required.Only 1 Partner per Entry.

First Name

Last Name

4

Your Email address to receive confirmation of your Case Race Entry.* This field is required.

example@example.com

5

Name of the Company/Case on the transmittal:* This field is required.

6

Verify your credits: View the COUNT ME IN Leaderboard (link below) in a new tab to see your total. You will need your current count to answer the final question and claim your credit.

HERE IS THE LINK:

CASE CASE LEADERBOARD AND TRACKER

7

How many case race credits have you achieved this case race?* This field is required.This is used for the leaderboard! How many times have you completed this form (April 1 - Sept 30, 2026) for each case?