HEIRS REVIEW FORM If you believe you are entitled to share in a deceased loved one's settlement fund- List the names of the deceased person and your relationship to them, and we will review with our records on file. Thank youYour First Name(Required)Your Last Name(Required)Your Date of Birth(Required) MM slash DD slash YYYY Email Address(Required) Phone Number(Required)Deceased First Name(Required)Deceased Last Name(Required)Your Relationship to Deceased(Required)If you believe a deceased loved one has children or grandchildren not listed in the lawsuit but should be considered to share in a settlement- please list their names and the relationship to the Deceased.Living HeirFull NameDate of BirthRelationship to Deceased Add RemoveSignature(Required)Date(Required) MM slash DD slash YYYY
