To complete, sign and submit a Proof of Claim electronically, please select from one of the below options:

Claimant Proof of Claim Form

Claimant Proof of Claim Form with Claimant Representative Authorization Form (claimant and claimant representative are available to sign)

Claimant Proof of Claim Form with Claimant Representative Authorization Form (claimant is not available to sign)

If you use this online version, you will not need to mail or email a Proof of Claim to the Receiver.  Instead, once you complete this online Proof of Claim Form, it will be automatically served on the Receiver’s Claims Agent.  If you serve an online Proof of Claim Form, please do not also serve a duplicate paper Proof of Claim Form.