Get Claim Form - Zurn Pex Plumbing Liability Litigation

Filling out the Claim Form for the Zurn Pex Plumbing Liability Litigation can seem challenging, but this guide will help you navigate the process effectively. By following these clear instructions, you can ensure your form is completed properly for submission.

Follow the steps to successfully complete and submit your claim.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your claimant information. Provide your full name or the business name if applicable, along with your Social Security Number or Tax Identification Number. Ensure that all fields marked as required are completed accurately.
3. Fill in your current mailing address, including city, state, and zip code. Make sure to include any foreign country if applicable.
4. Provide your phone numbers: daytime, evening, and cellular. Include your fax number and email, ensuring accurate contact information for correspondence.
5. Indicate your role by checking the appropriate box, such as plumber, tenant, builder, homeowner, insurer, owner of commercial property, or other.
6. Proceed to describe the property where the leak or reduced flow occurred. Enter the physical property address—do not use a post office box—and explain property ownership details.
7. If claiming on behalf of another, provide the necessary information about the person for whom you paid a claim. Ensure detailed documentation is included with your submission.
8. Detail your homeowners insurance if applicable, including the insurer's name and policy number.
9. In the section regarding the Zurn Pex F1807 fittings, explain how you determined the presence of these fittings. Multiple documentation options may apply, so check all that are relevant.
10. Document the loss in the section provided, answering questions about leaks, repairs, and reimbursements to accurately describe your circumstances.
11. Complete the claim history and settlements sections by answering questions about past leaks and claims related to the fittings.
12. Attach any additional information you feel is necessary in evaluating your claim and ensure you review all the completed information.
13. Certify and sign your form, confirming that all information is correct to the best of your knowledge.
14. Once all sections are completed, save any changes, and prepare for submission by downloading, printing, or sharing your completed form.

Start filling out your Claim Form online today to ensure your claim is submitted accurately and efficiently.