To obtain a Proof of Claim and Release Form simply click on the link, "Proof of Claim and Release Form" below. Once you have printed and completed the form, sign it, include copies of the required supporting documentation and return to the Claims Administrator so it is postmarked no later than, December 8, 2010.
If you have any questions when completing the Proof of Claim and Release Form please call the toll free number 1-877-690-7105 and we will be happy to assist you.