SUNZ Insurance Company - Loss History Affidavit 2026

1. Click ‘Get Form’ to open the SUNZ Insurance Company - Loss History Affidavit in our platform.
2. 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.
3. 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.
4. 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.
5. 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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