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Release Forms

Release Forms

The Artrhur, Chapman release forms can be found as follows:

1. General Releases

 

Complete Release

FULL04

Complete Release with Loss of Consortium

Full-LOC04

2. Minor’s Injury Releases

Standard Court Approved

MINOR04

 

Parent’s Indemnifying Release

PARENT04

3.

Wrongful Death Settlement

WD04

4.

No-Fault "Lump Sum" or "Closeout" Release

NO-FLT04

5.Pierringer- Type Releases

 

 

Simple Pierringer

PIER04

Pierringer with Loss of Consortium

PIER-LOC04

6. Work Related Injuries: Naig Settlements

 

Global Release

GLOBALWC-NAIG04

Simple Naig

NAIG04

Naig with Loss of Consortium

NAIG-LOC04

Reverse-Naig

REV-NAIG04

Reverse-Naig with Employer’s Claims

REV-NAIG-EMP04

Pierringer-Naig

NAIG-PIER04

7. Uninsured Motorist Releases

Simple UM Release

UM04

UM Release with Loss of Consortium

UM-LOC04

8. Underinsured Motorist Releases

Simple UIM Release

UIM04

 

UIM Release with Loss of Consortium

UIM-LOC04

 

Arthur, Chapman, Kettering, Smetak & Pikala, P.A.
500 Young Quinlan Building, 81 South Ninth Street Minneapolis, Minnesota (MN) 55402
Phone 866 435-5752 | Fax 612 339-7655 | Email Us | Clients Only