OUR FORMS
Please call Veronica Herrera @ (817) 850-9800 to complete these forms to save time and ensure accuracy.
These forms can be printed for fax or online submission. The Forms Package includes everything needed to begin the process, and many fields will automatically populate to save you time.
Please call Veronica Herrera @ (817) 850-9800 to complete these forms to save time and ensure accuracy.
Description of Forms:
PAGE 1: Automated Fillable Form auto-populate to save time.
PAGE 2: Verification Form – Is used to start the process. The information you provide is essential for us to provide you with a funding decision in a timely manner.
PAGE 3: Irrevocable Assignment/Reassignment – The top portion should be completed by the beneficiary(s) assigning the benefits to you, the funeral home. The bottom portion is completed by your authorized representative. Please NOTE: all signatures need to be notarized.
OPTIONS FOR COMPLETED FORMS:
Once you have completed the Forms, you may choose to either submit the claim online, fax back or email the forms for immediate submission. In addition, please send all original paperwork to our offices:
Forensic Autopsy Funding, L.L.C.
6750 Locke Ave, 3rd Floor
Fort Worth, Texas 76116
Office: (817) 850-9800
SUBMIT FORMS ONLINE
FAX FORMS
Fax: (817) 850-9801
Send all original paperwork to our offices:
Forensic Autopsy Funding, LLC
6750 Locke Ave, 3rd Floor
Fort Worth, Texas 76116
Office: (817) 850-9800
Try Forensic Autopsy Funding for
your
next Insurance Assignment
No Chargebacks Except in Cases of Fraud!
For all new clients, please contact Danny Smith, Co-Founder/Program Director.
Becoming a client with Forensic Autopsy Funding is both easy and secure.
Experience you can trust, service you can count on. Request a call-back to get more information