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Al instructions. CLAIM FOR DAMAGE, INJURY, OR DEATH 1. Submit to Appropriate Federal Agency: 2. Name, address of claimant, and claimant's personal representative if any. (See instructions on reverse). Number, Street, City, State and Zip code. Department of the Navy Office of the Judge Advocate General (Code 15) 1322 Patterson Ave SE; Bldg. 33; Suite 3000 Washington Navy Yard, D.C. 20374-5066 3. TYPE OF EMPLOYMENT 4. DATE OF BIRTH 5. FORM APPROVED OMS NO. 1105-0008 MARITAL STATUS 6. DA.

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How to fill out the Camp Lejeune Claims Packet Form online

Filing a claim using the Camp Lejeune Claims Packet Form can be a straightforward process if you follow the necessary steps. This guide aims to provide clear and supportive instructions to help you complete the form accurately and effectively.

Follow the steps to complete your claims packet form online.

  1. Press the 'Get Form' button to retrieve the claims packet form and access it for editing.
  2. Begin by filling in your name and address in the designated fields on the form. Include your street number, city, state, and zip code.
  3. Indicate your type of employment by selecting either 'military' or 'civilian.' Provide your date of birth in the specified field to confirm your identity.
  4. Provide your marital status and the date and day of the incident. Ensure that you accurately document the time of the event as either A.M. or P.M.
  5. Detail the basis of your claim. Clearly explain the facts surrounding the damage, injury, or death, and identify involved parties and property. Use additional sheets if necessary.
  6. If applicable, provide information regarding property damage. Include the property owner's name and address, followed by a brief description of the property's condition and damage.
  7. State the nature and extent of any personal injuries or the cause of death related to the claim. If the injured person is different from the claimant, provide their name.
  8. List any witnesses to the incident, including their names and addresses.
  9. Sign the form, providing your phone number and the date of your signature. Review the form for completeness before submitting.
  10. Once finished, you can save your changes, download, print, or share the completed form as needed.

Complete your Camp Lejeune Claims Packet Form online today.

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Camp Lejeune lawsuit settlement payouts for contaminated water exposure is estimated to be over $6.7 billion. Victims who pursue a Camp lejeune toxic water claim will receive lucrative settlements which could be well over $1 million in some cases.

Since the Camp Lejeune Justice Act of 2022 passed, you will likely need to hire a lawyer to help you file a lawsuit. An attorney with our firm can help walk you through the process and paperwork and act as your legal representation in your case.

In the Camp Lejeune cases, the primary injuries will be Parkinson's disease, lung cancer, leukemia, liver cancer, kidney cancer, and lymphoma. Based on these last points of comparison, our lawyers think the Camp Lejeune lawsuit cancer cases could have settlement amounts between $175,000 and $350,000.

4 Steps To Filing a Camp Lejeune Water Contamination Claim Determine Your Eligibility. To be eligible to file a claim under the Camp Lejeune Justice Act, you must have been: ... Collect Evidence. ... File an Administrative Claim. ... File a Case in Federal Court.

You'll need to fill out a Camp Lejeune Family Member Program Application (VA Form 10-10068) and send it to us by mail or fax.

6 Steps to File Your Camp Lejeune Water Lawsuit Prove you were at Camp Lejeune. You lived, worked, or were present at Camp Lejeune for 30 days (it doesn't have to be consecutive days) between August 1, 1953, and December 31, 1987. ... Show documentation of illness. ... File a VA claim. ... Lawyer up. ... File your lawsuit.

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