Submit a Claim
Please complete all required fields. The Fund Administrator will use this information for all communications regarding this request.
Using the provided template, also available here, provide a list of names, addresses, and email addresses (if available) of beneficial owners to the Fund Administrator for the Fund Administrator to mail the Plan Notice to such beneficial owners.
Do not make any edits to the template as your file will be rejected.
By signing below, I hereby certify that the foregoing information supplied by me is true, correct, and complete to the best of my knowledge.