Settlement Claim Form

This page contains links to the Settlement Claim Form. In order for you to fill it out, you must open and print the form off your computer. Depending on your computer, when you click the links below they may either initiate a download to your computer or open the form up on your computer in either MS Word or Acrobat Reader.

Claim Form (Word format)

PC Format: .doc (MS Word - 22.5 k)   

Claim Form (Acrobat format)

PC Format: .pdf (Adobe Reader - 89.7 k)