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Clemson University Accident Claim Form 2019-2025 free printable template

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First Agency 5071 West H Avenue Kalamazoo, MI 490098501ACCIDENT CLAIM FORM CLAIMANT/AUTHORIZED REPRESENTATIVE TO COMPLETEInsurance coverage is underwritten by Berkley Life and Health Insurance Company,
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How to fill out Clemson University Accident Claim Form

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How to fill out Clemson University Accident Claim Form

01
Obtain the Clemson University Accident Claim Form from the university's website or office.
02
Fill in your personal information at the top of the form, including your name, contact information, and student ID number.
03
Describe the accident in the designated section, providing details such as date, time, and location.
04
List any witnesses to the accident, including their contact information.
05
Provide a detailed description of your injuries or damages incurred from the accident.
06
Attach any relevant documentation, such as medical bills or photos of the accident scene.
07
Sign and date the form to certify that the information provided is accurate.
08
Submit the completed form to the designated office or department as instructed.

Who needs Clemson University Accident Claim Form?

01
Students or staff members who have been involved in an accident on campus or during university-sponsored activities.
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The Clemson University Accident Claim Form is a document used to report and claim for accidents that occur on university property or during university-sponsored activities.
Any individual who experiences an accident while participating in university activities, or an employee who witnesses an accident involving university property, is required to file the form.
To fill out the form, provide detailed information about the accident, including the date, time, location, description of the incident, and injuries sustained, along with the contact details of any witnesses.
The purpose of the form is to officially document the details of an accident, facilitate the claims process for potential medical expenses or damages, and enhance the university's safety measures.
The form requires reporting information such as the names and contact information of all parties involved, a detailed description of the accident, any injuries or damages incurred, and witness information.
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