Forms

Each legal matter requires a new Member Agreement and Case Description form. Before legal services can be performed, your attorney must have either a Plan A or Plan B Master Attorney Agreement on file with the Plan Office or you may give the attorney a form from your Plan Booklet to complete.

The Member Agreement will serve as a contract between you and your designated dependents, the attorney for the specific matter or matters listed therein, and the Plan.

The Case Description form should be completed by your attorney. This indicates the matter you are seeking legal services for and is very important in determining coverage for your claim.

The Statement of Financial Interdependence is only required if you are authorizing your same-sex domestic partner to use your benefit.

Attorney...please remember that a case description must be submitted for each new matter prior to payment.

You or your attorney may also print these forms from this website.

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