Fairbanks Claim Form

Claims may be filed as a paper copy claim form or electronically through the CPF e-File system.  Claimants or claimants' representatives must complete the standardized claim form in its entirety and sign the certification verifying the accuracy of the allegations or for a law firm to sign the e-File Agreement for electronic claim filing. Pro se claimants must file paper copy claims.  Valid medical documentation supporting the alleged injury and documentation establishing exposure to asbestos-containing products of or for which Fairbanks has liability must be submitted with the claim. Additionally, the claim must be submitted within the applicable deadline for filing a claim as set forth in the Fairbanks Asbestos Personal Injury Trust Distribution Procedures Section 5.1(a)(2).

Click here to download the Fairbanks Trust Claim Form.