Get Wrongful Death Interview Form #15 - Conrad Trosch & Kemmy

Filling out the Wrongful Death Interview Form #15 is an important step in seeking legal assistance after a tragic loss. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your full name in the designated field, including your first, middle, and last names.
3. Input your birthdate, formatted as month/day/year.
4. Provide your Social Security number in the specified format.
5. If applicable, include your maiden name in the appropriate section.
6. Fill out your address details, including street number, city, county, state, and zip code.
7. If it is not appropriate to send mail to your address, indicate an alternative address for correspondence.
8. Enter your phone numbers, including home, work, and any other relevant numbers.
9. Provide the name and phone number of an alternate contact for emergencies.
10. Indicate who referred you to the law firm.
11. Record the date of the incident in the specified format.
12. List the car insurance provider and include the policy and claim numbers.
13. Answer whether the decedent had health insurance, and if so, provide the employer’s information and insurance details.
14. Indicate if the decedent received Medicare benefits and provide their Medicare number.
15. Provide details about the decedent’s place of employment and a brief job description.
16. Describe the incident briefly, ensuring to include essential details.
17. State whether a police report was filed and provide the responding police department and report number.
18. Indicate if you have photographs related to the accident.
19. Mention the injuries suffered by the decedent.
20. If applicable, detail any surviving children, spouse, or living parents, including their names and relationships.
21. Clarify your relationship to the decedent.
22. List funeral expenses, tax returns, and the decedent's salary.
23. Indicate whether the decedent provided care for anyone.
24. State whether the decedent was a veteran.
25. Complete the section regarding the opposing party if applicable, including their name, address, employer, and insurance details.
26. Once you have filled out all sections, review the form for accuracy. Save any changes made.
27. Download, print, or share the completed form as needed.

Start filling out your documents online today for efficient and accurate completion.