Get Written Statement Template

Filling out the Written Statement Template online can be a straightforward process when you have clear guidance. This guide will help you understand each section of the form and provide step-by-step instructions for successful completion.

Follow the steps to fill out the Written Statement Template effectively.

1. Press the ‘Get Form’ button to access the Written Statement Template and open it in your preferred online editor.
2. In Section A, enter your claimant information. Provide your last name, first name, middle initial, your Deepwater Horizon Settlement Program claim number, and your social security number or individual taxpayer identification number. Additionally, fill in your current street address, city, state, and zip code.
3. Proceed to Section B, which requires the information of the canceling party. Include their name, current address, city, state, and telephone number. You must also provide their social security number or ITIN, and if applicable, the employer identification number and the name of the authorized business representative.
4. In Section C, detail the cancellation of the event. Start by providing a description of the event, including the type or nature of the event, the date(s) it occurred, and the location. Also, clarify your relationship to the event.
5. Continue in Section C with the causation information. Indicate that you or your business canceled the event due to the Deepwater Horizon spill, specifically between April 21, 2010 and December 31, 2010.
6. Next, address the loss to the claimant. If you lost income due to the cancellation, fill in the appropriate amounts for the contract and any variation in payment to you. If you did not lose income, indicate this option here.
7. Finally, in Section D, ensure that you review and certify the information provided. Sign and date the statement to verify that all details are accurate to the best of your knowledge.
8. After filling out the form, use the options available to save your changes, download the document, print it for your records, or share it as needed.

Complete your Written Statement Template online today and ensure your information is submitted accurately.