ACTL004. Claim Form – Deceased

Please download the form and submit it along with all required documents below.

To complete this form electronically, you’ll need software such as Adobe Acrobat Reader, which you can download for free.

If you are unable to fill out the form electronically, you can download and print it. After completing it by hand, please return it to us with all necessary documents using one of the methods provided in the form.

If you need assistance, please don’t hesitate to contact us.

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