Get Qualified Claimant's Statement

Filling out the Qualified Claimant's Statement is a crucial step in making a claim with Lincoln Financial Group. This guide provides clear instructions on how to complete each section of the form online, ensuring your submission is accurate and complete.

Follow the steps to accurately complete your Qualified Claimant's Statement.

1. Press the ‘Get Form’ button to access and open the Qualified Claimant's Statement in your preferred online editor.
2. Begin by entering the deceased's information in the specified fields including the claim number, contract number(s), first name, middle name, last name, social security number, and date of death. Ensure that all entries are accurate and match your records.
3. Next, fill out your information as the claimant. Include your first name, last name, middle name, and any applicable details if you are submitting on behalf of an entity. Provide your date of birth, social security number or EIN, mailing address, daytime and evening phone numbers, and email address. Select your relationship to the deceased from the provided options.
4. Choose your preferred payment method by selecting one of the provided options and filling out any subsequent necessary details based on your selection. Be sure to read the descriptions of each option carefully to select the most suitable choice for your needs.
5. Complete the tax withholding section as required. Indicate your preferences regarding federal and state tax withholding by selecting the appropriate options and filling in any percentages or dollar amounts.
6. In the election of beneficiary section, designate primary and contingent beneficiaries, ensuring that the total percentages equal 100%. Complete all fields for each beneficiary, including their name, relationship, and contact information.
7. Authorize transactions by checking the appropriate box if you want to permit instructions via electronic means. Understand the implications of this authorization before making your choice.
8. Certify the information provided in your claim. Carefully read through the certification statement, check the box confirming your understanding, and fill in your legal name, title (if applicable), and signature date.
9. After completing the form, review all entered information for accuracy. Once satisfied, save your changes, and you may choose to download, print, or share the form as required.

Complete your Qualified Claimant's Statement online today to ensure timely processing of your claim.