APPLICATION FORMS

GENERAL INSTRUCTIONS

 

Please read the instructions carefully and follow them in filling out the application as best you can. If an application asks about governmental benefits such as SSI or Husky C, please provide accurate information. 

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Please note that the Trustee is only able to process your application on the information you provide. The Trustee has no responsibility or liability if the payment of any settlement amount results in ineligibility for any governmental program.