Clja Claim Form. Be sure to save the form as “last name first name. Sign online button or tick the preview image of the form.
Claim Application PDF PDF
Sign online button or tick the preview image of the form. The form includes the victim, or claimant, contact info, date of exposure, housing location, and illness. The claim form also requires the signature of an authorized agent who can validate the information on the form if the victim is filing the claim with the help of an attorney. Web the clja claim form asks for basic information on dates of military service, when the victim lived or worked at camp lejeune, basic injury information and more. The advanced tools of the editor will direct you through the editable pdf template. Web tips on how to complete the camp jejune claims packet form online: Be sure to save the form as “last name first name. Submit to appropriate federal agency: To start the document, utilize the fill camp; Office of the judge advocate general tort claims unit norfolk 9620 maryland a venue, suite 205 norfolk,.
You will need the latest version of adobe acrobat to use this form. Web if you desire to file a claim under the clja, please fill out the clja claims form according to the directions below, and attach all requested documents. Enter your official contact and identification details. Web section 804 of this law is the camp lejeune justice act of 2022 (“clja”), which allows new lawsuits for individuals exposed to contaminated water at camp lejeune. Office of the judge advocate general tort claims unit norfolk 9620 maryland a venue, suite 205 norfolk,. Be sure to save the form as “last name first name. Web tips on how to complete the camp jejune claims packet form online: Sign online button or tick the preview image of the form. Mail or another carrier to the following address department of the navy office of the judge advocate general tort claims unit norfolk attention. The claim form also requires the signature of an authorized agent who can validate the information on the form if the victim is filing the claim with the help of an attorney. Web submit a completed clja claims form via u.s.
