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CLAIM INTAKE
Do you claim that you are entitled to monetary damages from the School District of Philadelphia? Fill out the form and we will get back to you shortly.
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Email
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Your email
PERSONAL INFORMATION
Claimant Last Name
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Your answer
Claimant First Name
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Your answer
Claimant Telephone Number
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Your answer
Claimant Street Address
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Your answer
City/Town
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Your answer
State
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Your answer
Postal Code
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Your answer
Claimant Date of Birth
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Are you the Claimant?
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If you are not the Claimant, what is your relationship to the Claimant?
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Parent/Guardian
Attorney
Insurance adjuster
Insurance agent
Employee
Child
Authorized reprentative
Power of Attorney
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If you are not the Claimant, please provide your contact information (email, address, telephone number) here:
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