INSTRUCTIONS : Please complete both sections of this form, have both sections notarized, and Preview on Page 1

INSTRUCTIONS : Please complete both sections of this form, have both sections notarized, and 2026

Here's how it works

  • 01. Edit your form online

    Type text, add images, blackout confidential details, add comments, highlights and more.

  • 02. Sign it in a few clicks

    Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

  • 03. Share your form with others

    Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out the CLAIM AND RELEASE FORM

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open it in the editor.
  2. In the CLAIM SECTION, fill in your name, address, and contact information. Ensure all details are accurate as they will be used for verification.
  3. Specify the claim amount in both written and numerical form. Provide a brief description of the incident that led to your claim. If more space is needed, attach additional pages.
  4. Sign the CLAIM SECTION where indicated. This signature must be notarized, so ensure you have a notary public present when signing.
  5. In the RELEASE SECTION, acknowledge receipt of payment by filling in the amount received. Sign this section as well, ensuring it is also notarized.
  6. Complete any required agency sections after submitting your form for approval. Make sure to return three copies with original signatures as instructed.

Start using our platform today to streamline your document editing and signing process for free!

See more INSTRUCTIONS : Please complete both sections of this form, have both sections notarized, and versions

We've got more versions of the INSTRUCTIONS : Please complete both sections of this form, have both sections notarized, and form. Select the right INSTRUCTIONS : Please complete both sections of this form, have both sections notarized, and version from the list and start editing it straight away!

VersionsForm popularityFillable & printable
20194.8 Satisfied (48 Votes)

be ready to get more

Complete this form in 5 minutes or less

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

For most employees, the process will take less than one business day to complete, once the I-9 form has been sent to Simplei9.com. How do I sign up for the E-Verify process through Simple I-9?
For gamers, an i9 processor can docHubly improve frame rates and overall gaming experience, especially in CPU-intensive games. The high clock speeds and multiple cores allow for smoother gameplay, faster load times, and the ability to run multiple applications simultaneously without compromising performance.
You must provide your legal name, complete address, date of birth, U.S. citizenship or immigration status; including Alien Number/USCIS Number, Form I-94 admission number, or foreign passport number and country of issuance and the date employment authorization expires if applicable; and signature and the date.
An I-9 form is not a background check. Many employers conduct pre-employment background screenings to verify a candidates prior employment, education, references, criminal history, or driving record. This is different from employment eligibility verification.
Documents you need Examples: Primary document: Drivers license, passport, or other government-issued photo. Secondary document: Social Security card, utility bill, or vehicle registration.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

People also ask

Make Your Request Online. Our online FOIA request service is the fastest, most convenient way to request and receive records from USCIS. Requests Using Form G-639. Mail Requests Without Form G-639. Be Specific. Make a Separate Request for Each Person. Where to Mail.
You should review Form I-9, Employment Eligibility Verification, immediately after completion to avoid these common mistakes. In Section 1, common mistakes made by employees include: Employee does not enter name, other last names used (such as maiden name), address or date of birth.

Related links

RP-5217-PDF Real Property Transfer Report Instructions

The RP-5217-PDF Real Property Transfer Report (RPL Article 9, Section 333) is a one-part, downloadable, barcoded, pdf form used to document the informationRead more

Learn more
Applicant Affirmation Form

(Complete Section 1, 2, and 4) Section 4: Statements and Signatures (Notary signature and seal is required for individual applicant) Notarization (required for

Learn more
Notary Public Educational Information

To complete the education requirement and learn how to become a notary public, please go to our Notary Public page and read our instructions. TraditionalRead more

Learn more
If you believe that this page should be taken down, please follow our DMCA take down process here