Claimant Information

✓Claim Details

2Your Info

3Choose Service

4Agreements

Step 5: Claimant Information

We only collect basic contact information to create your claim and send updates. We do not request Social Security numbers or date of birth.

First Name

Last Name

Phone (optional)

Mailing Address (optional)

Some jurisdictions mail checks/notices. If you prefer, you can add this later.

City (optional)

State (optional)

ZIP (optional)

Preferred Contact

Notes (optional)

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Your contact information