Get Lincoln Glc-01363 2017-2025

This guide provides a clear and supportive approach to completing the Lincoln GLC-01363 form online. Whether you are familiar with such forms or new to them, our step-by-step instructions will help you navigate the process effectively.

Follow the steps to fill out your form correctly.

1. Click 'Get Form' button to obtain the form and open it in the online editor.
2. Begin by entering your full name in the designated field, including your last name, first name, and middle initial.
3. Fill in your Social Security Number accurately in the provided section.
4. Provide your street and mailing addresses in the respective fields.
5. Enter your phone number, ensuring to include the area code.
6. Specify your city, state, and zip code in the relevant fields.
7. Input your email address and indicate if you consent to be contacted via email by selecting 'Yes' or 'No.'
8. Enter your employer's name and the group policy number.
9. Fill in your date of birth in the provided format.
10. Complete the employer's phone number section.
11. Indicate the date when you last worked.
12. Specify your gender and the date of disability, choosing the appropriate option.
13. Answer whether you have had the same or similar condition in the past and provide relevant dates if applicable.
14. Describe your illness or how your injury occurred in detail.
15. Confirm whether you were hospital confined and provide relevant dates.
16. Indicate whether your disability is due to sickness, injury, or other circumstances.
17. Provide details regarding your height and weight.
18. Indicate if you have returned to work part-time or full-time, and the respective dates.
19. Specify whether your disability is related to your occupation and explain if applicable.
20. Indicate if you plan to file a Workers' Compensation Claim.
21. List any doctors who have treated you for this disability along with their contact details.
22. Decide whether Lincoln should withhold Federal Income Taxes from your benefits and specify the amount.
23. Describe any other income you are receiving or intend to apply for, including amount and relevant dates.
24. Read and confirm the statement declaring the truth and completeness of your provided information.
25. Sign the form and date it in the specified area.
26. Select your payment method and provide the necessary bank details for direct deposit.
27. After completing all sections, save your changes, and consider downloading, printing, or sharing the form as needed.

Complete your documents online today to ensure a smooth process.