Get Nike Claims Form

Filling out the Nike Claims Form online can seem overwhelming, but with a detailed guide, the process becomes straightforward. This guide provides step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the Nike Claims Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your account holder information. Fill in your member ID, phone number, Social Security number or unique ID number, and your name with your last name first, followed by your first name.
3. If you have a new address, indicate this by checking the 'YES' box and provide your address details, including apartment number, street, city, state, and zip code. Additionally, enter your email address and employer name.
4. Proceed to the claims section by entering out-of-pocket expenses. For each dependent, fill in their name, date of birth or age, service start date, service end date, and the out-of-pocket cost.
5. Provide the name of the service provider along with their Social Security number or tax ID number. Ensure you gather and have documentation ready if necessary.
6. You may have a provider sign the form if applicable, although it is not required. This signature will replace the need for other proof of service.
7. If you have more expenses to claim, complete another form, as needed.
8. Total the expenses on the form and certify your request for reimbursement. Also, confirm that these expenses are not covered by any other source and adhere to all applicable tax regulations.
9. Finally, sign and date the form in the designated areas. Only the account holder's signature is acceptable, not that of a spouse or dependent.
10. After completing all fields, save the changes to your form. You can then download, print, or share your completed form.

Complete your Nike Claims Form online today for a smooth reimbursement experience.