Get Ustcf Non Recovery From Other Sources Disclosure Certification - Swrcb Ca

Completing the USTCF Non Recovery From Other Sources Disclosure Certification is an important step in the claims process related to underground storage tank cleanup. This guide will provide you with clear, step-by-step instructions on how to effectively fill out the form online, ensuring that all necessary information is provided accurately.

Follow the steps to successfully complete your certification form.

1. Click the ‘Get Form’ button to access the USTCF Non Recovery From Other Sources Disclosure Certification form. This will allow you to open and edit the document in an online format.
2. Begin by filling in your name and the name of any joint claimant, if applicable. Enter the site address and your claim number at the top of the form.
3. Indicate whether you or the joint claimant is completing the certification. Note that a separate copy of this form must be signed by each claimant.
4. Answer the questions regarding insurance. State whether there has ever been an insurance policy covering the site and provide necessary details if applicable, including company name, policy number, and claim representative's contact information.
5. Respond to questions about any filed claims with insurance carriers. If applicable, attach an explanation of the claim status and the latest correspondence with the insurance company.
6. Address the litigation section by indicating whether you have sought or plan to seek compensation from any other parties responsible for the contamination. If yes, provide details about those parties.
7. Detail any other sources of compensation for the unauthorized release. If you have received any funds related to this issue, list the sources and amounts, attaching copies of related documentation.
8. Complete the agreements and declarations section carefully. Review your obligations and ensure you understand the ramifications of inaccurate information.
9. Execute the form by signing it and dating it appropriately. If applicable, ensure that all joint claimants also sign.
10. Once all sections are completed, save changes to the form. You can then download it or print it for your records.

Complete your USTCF Non Recovery From Other Sources Disclosure Certification online today.