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Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
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Send individual economic via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out economic loss claim with our platform
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Click ‘Get Form’ to open the Individual Economic Loss Claim Form in the editor.
Begin by filling out Section A, 'Claimant Information.' Enter your last name, first name, middle initial, and Social Security Number or Individual Taxpayer Identification Number.
In Section B, select your Compensation Period. Choose a period of at least 90 consecutive days after the Spill that aligns with your pay periods.
Proceed to Section C to provide details about your Claiming Job(s). Include employer information, employment dates, and job description.
Complete Section D by selecting your Base Year(s) for earnings history. This will help establish expected earnings during the Compensation Period.
Finally, review all sections for accuracy and completeness before submitting your claim through our platform.
Start filling out your economic loss claim today for free using our platform!
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