Get Advancement Or Lump Sum Request Form

Filling out the Advancement Or Lump Sum Request Form online can be a straightforward process if you follow the appropriate steps. This guide provides clear instructions to help you complete the form efficiently and correctly, ensuring that all necessary information is included.

Follow the steps to fill out the form online:

1. Click ‘Get Form’ button to obtain the form and open it in your preferred digital editing tool.
2. Begin by indicating whether you are the injured worker or the injured worker’s surviving spouse. This information is crucial for processing your request appropriately.
3. Provide your complete personal information, including your name, address, telephone number, city, state, ZIP code, email address, and cell phone number.
4. Specify the type of compensation you are currently receiving that you wish to advance. This detail helps in understanding your request.
5. Clearly state the exact amount you are requesting and the reasons for the advancement. This information should be detailed to support your request.
6. If applicable, list any co-payee(s) along with the exact amount designated for each. Ensure that you attach an additional sheet if needed.
7. Sign the application. Remember, your signature must be notarized for the document to be valid.
8. Save your changes, and ensure that you download, print, or share the completed form as needed before submitting.
9. Return the completed form to the BWC customer service office managing your claim for further action.

Complete your forms online today for a seamless experience.