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SUNZ Insurance Company - Loss History Affidavit 2026
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- Click ‘Get Form’ to open the SUNZ Insurance Company - Loss History Affidavit in our platform.
- Begin by filling in the 'Company Information' section. Enter the name of the owner/officer and the legal name of the company. Ensure accuracy as this information is crucial for validation.
- In the 'Loss History Acknowledgement' section, select one of the two options regarding work-related injuries. If applicable, provide details about any injuries experienced in the past three years, including employee names, injury dates, types of injuries, and total claim costs.
- If there are more claims than can fit on the form, attach an additional sheet using the same format to ensure all information is captured.
- Finally, sign and date the affidavit at the bottom. If a PEO representative is involved, they must also complete their section with acknowledgment.
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The attached form was a SUNZ [Insurance Company] Loss History Affidavit. Id. at 155. (Nov. 21, 2018 email); see also id. at 20910 (Loss History Affidavit).Read more
2012 annual report ; Collection: Georgia Government Publications ; Serial: Annual report.. ; Title: 2012 annual report ; Creator: Georgia. Subsequent Injury TrustRead more