Use this screen to access and electronically sign your Stipulation of Termination of All Claims and/or General Release and Indemnity for Claimed Injury Tier 2 Program Participants. Enter your Date of Birth and the last four digits of your Social Security Number and then click Search.

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If you have issues accessing the Form, you may contact the Claims Administrator by phone, 1-888-724-0247, or email, ClaimsAdministrator@BrownGreerJFM.com, for assistance. Direct all other questions to your lawyer.