Get Supplementary Claimants Statement - Ajgrmscom

Filling out the SUPPLEMENTARY CLAIMANTS STATEMENT - Ajgrmscom is a straightforward process that requires careful attention to detail. This guide will help you navigate each section of the form to ensure accuracy and clarity in your submission.

Follow the steps to complete your supplementary claimant statement online.

1. Click the ‘Get Form’ button to retrieve the form and open it in your preferred editing tool.
2. Begin by entering your full name and unit number in the designated fields.
3. Provide your social security number in the appropriate section.
4. Answer question 1 by indicating the date you resumed partial duties of your occupation.
5. In question 2, list the duties you were able to perform as of that date.
6. Clearly state the duties you were unable to perform in question 3.
7. Complete question 4 by mentioning the date you returned to full duties.
8. For question 5, if you have not returned to full duties, provide an expected date for return.
9. Respond to question 6 about hospital confinement since your last payment, including the name and address of the hospital if applicable.
10. Indicate whether you are presently house confined in question 7, and if no, provide the date you were first able to leave your home.
11. Certify the accuracy of your statements with your signature and date.
12. Complete the authorization section, sign, and date it again.
13. Fill in your address in the final field.
14. After reviewing all entries for accuracy, save the changes, download, print, or share the form as needed.

Complete your documents online with confidence and ensure timely submission of your claims.