Claim Form

To submit a claim online Fill Out Our Online Claim Form.
Alternate printable versions of this form are available for download below.

PDF Version - Best for printing and can be read on lots of different kinds of computers. You will need the free Acrobat Reader to view and print this file.
1) Print the Form
2) Fill it out
3) Attach any additional files that support your claim
4) Mail or Fax to:

FINANCIAL CLAIMS INCORPORATED

Mail: P.O. Box 3029 Kirkland, WA 98083-3029

Fax: (425) 821-3106

(Microsoft Word) Version
1) Open the Form using Microsoft Word or Word Pad
2) Fill out the form - you can even modify it to include additional text to describe your claim.
3) If you prefer, you can print the blank form and fill it out with a pen.
4) Mail or Fax to:

FINANCIAL CLAIMS INCORPORATED

Mail: P.O. Box 3029 Kirkland, WA 98083-3029

Fax: (425) 821-3106

5) Send via Email as an attachment to:

newclaims@financialclaims.net.

Mail: P.O. Box 3029 - Kirkland, WA - 98083-3029
Phone: (425) 820-3321 - Toll Free: (800) 258-4370 - Fax: (425) 821-3106
Home | Company Overview | Our Services | Rates and Terms | Claim Form
Payment Choices | Contact Us | Links | Status Now | Passive Accounts