This is an affidavit by a representative of an insurance company that is evidence that an insured loss was caused by lightning.
Pennsylvania Affidavit - Lightning Losses by Repairman or Appraiser
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How to fill out Affidavit - Lightning Losses By Repairman Or Appraiser?
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FAQ
Your personal belongings are also typically covered for damage caused by lightning under the personal property coverage on your homeowners policy. This includes damage to your electronics and appliances caused by a power surge resulting from a lightning strike.
If your car is struck by lightning, comprehensive coverage can help you pay to repair or replace your vehicle. If you don't carry comprehensive coverage, you will have to pay for any damage out of pocket.
Proving Damage was Caused by Lightning As soon as it is safe to do so, take pictures of the damage to show to the insurance company. If lightning strikes the ground on your property or near your home, it can also damage your plumbing as well as your electrical system.
The good news is that lightning strikes, as well as fire caused by lightning, are covered perils in almost all homeowners insurance policies, with no exclusions.
The lightning loss affidavit is completed by a service provider (usually a licensed electrician) who inspects the damage and confirms under oath that lightning was the source of the damage.