Get Request For Review - Pre-1986/post-1990 Hepatitis C Settlement ...

Filling out the Request For Review form is an essential step for individuals seeking to appeal the decision made by the Administrator regarding their Hepatitis C claims. This guide provides clear and helpful instructions on how to complete the form accurately and effectively.

Follow the steps to complete your appeal request.

1. Click the ‘Get Form’ button to obtain the Request For Review form and open it in your preferred digital editor.
2. Begin with Section A, where you must provide details about the HCV infected class member. Input their last name, first name, middle initial, home address, city, province or territory, postal code, country, date of birth, and contact numbers.
3. If you are submitting the claim on behalf of another person, complete Section B. Ensure you fill in the same details for the HCV infected class member as mentioned in Section A.
4. In Section C, confirm if the place of residence on July 9, 2007, matches the address provided in the previous sections. If it does not, complete the necessary information.
5. Move on to Section D, where you need to select the appropriate status for the claimant by checking the applicable box. Choose from options such as primarily-infected class member, secondarily-infected person, or approved family member.
6. In Section E, indicate the type of appeal you are filing by checking the relevant box. You will also need to specify the reasons for appealing the Administrator's decision.
7. At the end of the form, provide the date you are signing, and include the claimant's signature, their print name, and the file number. Ensure all details are accurately filled out before submission.
8. Once you have completed the form, save your changes, and download or print a copy for your records. You may also choose to share the form as necessary.

Begin filling out the Request For Review form online today to ensure your appeal is submitted timely.