CRITICAL CLAIM DOCUMENTS:
This section contains all the documents and information necessary to complete the claim process. You may submit your claim electronically or by mail. These documents may be printed off the Web site, or you may write to the Trust and we will send you the documents that you request.
Claim Form
Claim Form (Word)
Claim Form (PDF)
Claim Checklists
Grade II
Grade I
Enhanced
Serious Asbestosis
Other Cancer
Other Organ Cancer
Lung Cancer
Mesothelioma
Trust Approved Interrogatories
California Claim Form Interrogatories — Personal Injury (PDF)
California Claim Form Interrogatories — Personal Injury ) (Word)
California Claim Form Interrogatories — Wrongful Death (PDF)
California Claim Form Interrogatories — Wrongful Death (Word)
Minnesota Claim Form Interrogatories (11/09/04)
Sample Verification for Answers to Interrogatories (08/19/04)
Litigation Declaration
Litigation Declaration — Claimant (08/12/04)
Litigation Declaration — Attorney (08/12/04)
Traditional Occupation List
Occupational List (07/26/05) (PDF)
Occupational List (07/26/05) (Excel)
Third Party Disclosure
Disclaimer
Pursuant to Section VII, subsection b, of the Case Valuation Matrix, the site/ship lists may be modified in light of additional evidence or experience with claims processing. However, if a claim is submitted with exposure at a site or on a ship which is subsequently removed from the approved list after the claim was submitted and before it is approved for payment, the claim’s filing fee will be fully refunded.
Site List
California On Land Site List (September 2020) (PDF)
California On Land Site List (September 2020) (Excel)
California On Land Site List_Deleted Sites
Minnesota On Land Site List(02/17/2011) (PDF)
Minnesota On Land Site List (02/17/2011) (Excel)
Minnesota On Land Deleted Site List (06/18/2008) (PDF)
North Dakota On Land Site List (03/06/2009) (PDF)
North Dakota On Land Site List (03/06/2009) (Excel)
Ships List
Western Build Ship List Items Approved 2.16.2024) (Excel).
Western Ships Repaired List 11.2024 (PDF)
Western Ships Repaired List 11.2024 (Excel)
Western Ships Built List Revised (02/2024) (PDF)
Western Ships Built List Revised (2.2024) (Excel)
Western Ships Built List – Deleted Ships (04/17/2008) (PDF)
How to Add a Site or Ship to the List
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