The Asurion F-017-08 MEN form is a document used for specific claims and services related to device protection plans. This form helps streamline the process for customers seeking assistance with their devices. To get started, fill out the form by clicking the button below.
The Asurion F-017-08 MEN form serves as a crucial document for individuals engaging with Asurion's services, particularly in the realm of electronics protection and warranty claims. This form typically encompasses essential information that customers must provide to facilitate the processing of claims or service requests. Key sections often include personal identification details, a description of the device in question, and the specific nature of the claim being filed. Additionally, the form may require customers to outline any previous interactions with Asurion regarding the issue at hand. Understanding how to accurately complete this form can significantly streamline the claims process, ensuring that customers receive timely assistance and support. By being aware of the required information and the overall purpose of the Asurion F-017-08 MEN form, users can navigate the claims process with greater confidence and clarity.
How to Submit the Required Documentation
&KRRVHDQRSWLRQ2QOLQHRU)D[DQGIROORZWKHVWHSV
DO NOT FAX THIS PAGE
2QOLQH5HFRPPHQGHG
11SJOU mMMPVUBOETJHOUIF4XPSO"GmEBWJU1SPPGPG-PTT4UBUFNFOU
)RXQGRQSDJHRIWKLVGRFXPHQW
4DBOPSUBLFQJDUVSFTPGCPUIUIFDPNQMFUFEBGmEBWJUBOEZPVSWBMJEQIPUP*%
$FFHSWDEOHIRUPVRISKRWR,'YDOLGGULYHU·VOLFHQVHSDVVSRUWIHGHUDOO\LVVXHG,'FDUGRUPDWULFXODFRQVXODU,'
36QMPBECPUIEPDVNFOUTBUQIPOFDMBJNDPNNFUSPVQMPBEFS
)D[
1IPUPDPQZZPVSWBMJEQIPUP*%BOEIBOEXSJUFZPVS$MBJN*%OVNCFSPOUIFQBQFS
3 'BYCPUIEPDVNFOUTUP
+RZWRSUHYHQWGHOD\VLQSURFHVVLQJ\RXUFODLP
7KHGRFXPHQWLVPDUNHGZLWKDEDUFRGHWKDWLVVSHFLÀFWR\RXUFODLP8VLQJDSKRWRFRS\ZLWKDQLQFRUUHFWEDUFRGHZLOOGHOD\\RXUFODLP 0DNHVXUH\RXKDYHDYDOLGSKRWR,'
•$FFHSWDEOHIRUPVRISKRWR,'YDOLGGULYHU·VOLFHQVHSDVVSRUWIHGHUDOO\LVVXHG,'FDUGRUPDWULFXODFRQVXODU,'
•8QDFFHSWDEOHIRUPVRI,'VWXGHQW,'ZRUN,'ELUWKFHUWLILFDWH, military ID, common access card,DQG6RFLDO6HFXULW\FDUG
•1DPHRQWKH,'PXVWPDWFKQDPHRIWKH0HWUR$FFRXQW2ZQHUZKRFRPSOHWHVWKH6ZRUQ$IÀGDYLW 3URRIRI/RVV6WDWHPHQW
•,IQDPHGRHVQRWPDWFKWKHQ\RXPD\QHHGWRSURYLGHDGGLWLRQDOGRFXPHQWDWLRQ
•7KH,'FDQQRWEHH[SLUHG,IWKH,'DSSHDUVDOWHUHGIRUJHGLOOHJLWLPDWHRUXQUHDGDEOHZHZLOOQRWEHDEOHWRSURFHHGZLWK\RXUFODLP
0DNHVXUHDOOGRFXPHQWVFDQVRUID[HVDUHFOHDUDQGHDV\WRUHDG
•:KHQPDNLQJWKHSKRWRFRS\RI\RXUSKRWR,'FRQVLGHUXVLQJWKHHQODUJHDQGFRQWUDVWVHWWLQJVWRPDNHWKH,'HDVLHUWRUHDG
•%ODFNDQGZKLWHFRSLHVDUHSUHIHUUHG
+RZWRÀQG\RXUGHYLFHPDQXIDFWXUHUPRGHODQG(610(,',0(,
)RUPRVWGHYLFHV
For Android products:
)RU$SSOHSURGXFWV
)LQGWKLVLQIRUPDWLRQRQ
•/RJLQWRJRRJOHFRPGDVKERDUG
•2SHQL7XQHV
• %DFNRIWKHSKRQHGHYLFHRUXQGHUWKHEDWWHU\
•&OLFNWKH$QGURLGVHFWLRQWRGLVSOD\
•&KRRVHL7XQHV!3UHIHUHQFHVLQ0DF26;
QRWDOOEDWWHULHVDUHDFFHVVLEOH
(610(,',0(,
•&KRRVH(GLW!3UHIHUHQFHVLQ:LQGRZV
•<RXU&XVWRPHU$JUHHPHQW
•&OLFNWKH'HYLFHVWDE
DYDLODEOHDWSKRQHFODLPFRPPHWUR
•3RVLWLRQWKHPRXVHRYHU´%DFNXS'HYLFHµ
•7KHER[WKHSKRQHGHYLFHFDPHLQWRGLVSOD\(610(,',0(,
•,IQRQHRIWKHVHLWHPVDUHDYDLODEOHSOHDVHFRQWDFW 0HWUR
9LVLWXVRQOLQHDWSKRQHFODLPFRPPHWURRUFDOO$VXULRQDWIRUTXHVWLRQVUHJDUGLQJWKHFODLPVSURFHVV
Sworn Affdavit & Proof of Loss Statement
5)*4%0$6.&/5.645#&$0.1-&5&%#:"/"$$06/508/&30/:063.&5308*3&-&44"$$06/5
5)&1&340/$0.1-&5*/(5)&%0$6.&/5.645"-401307*%&"1)050$01:0'5)&*37"-*%1)050*%
,1685$1&()5$8',6$&5,0(
)RU\RXUSURWHFWLRQDSHUVRQZKRNQRZLQJO\SUHVHQWVDIDOVHRUIUDXGXOHQWLQVXUDQFHFODLPZLWK WKHLQWHQWWRLQMXUHGHIUDXGRUGHFHLYHDQ\LQVXUHULVJXLOW\RIDFULPHDQGPD\EHVXEMHFWWR ÀQHVDQGFRQÀQHPHQWLQSULVRQ:KHQIUDXGLVGLVFRYHUHG$VXULRQWDNHVDSSURSULDWHVWHSVWR
VWRSVXFKIUDXGDQGH[SORUHVDOORILWVDYDLODEOHOHJDOUHPHGLHV
:KDWGHYLFHDUH\RXFODLPLQJ"$//),(/'6$5(5(48,5('3/($6(35,1786,1*%/8(25%/$&.,1.
Claim ID:
0DQXIDFWXUHU
&YBNQMFT4BNTVOH -( ;5& FUD
:LUHOHVV1XPEHU
0RGHO
&YBNQMFT(BMBYZ4 ' ;."9 FUD
3FGFSUPUIFJOTUSVDUJPOTPOUIFQSFWJPVTQBHF
:KDWKDSSHQHGWRWKHGHYLFH"
0\'HYLFH,V /RVW 6WROHQ 'DPDJHG 0DOIXQFWLRQLQJ
'DWHRI2FFXUUHQFH
3ODFHRI2FFXUUHQFH
'HVFULEH:KDW+DSSHQHG
$FFRXQW2ZQHULQIRUPDWLRQ
)XOO1DPH
3ULPDU\3KRQH
$OWHUQDWH3KRQH
Email Address:
%LOOLQJ$GGUHVV
&LW\
6WDWH
Zip Code:
&ODLPDJUHHPHQW
,KHUHE\PDNHDQLQVXUDQFHFODLPDJDLQVWWKHLQVXUDQFHFRPSDQ\DVVKRZQRQWKLVLQVXUDQFHFODLPDIÀGDYLW,DFNQRZOHGJHWKDWLIDQ\SURSHUW\ZKLFKLVWKHVXEMHFWRI WKLVFODLPDQGZKLFKLVUHSODFHGRUSDLGIRUE\WKHLQVXUHULVUHFRYHUHGDWDQ\WLPHLWLVWKHSURSHUW\RIWKHLQVXUDQFHFRPSDQ\DQGPXVWEHUHWXUQHGWRWKHLQVXUDQFH FRPSDQ\,XQGHUVWDQGWKDWLI,IDLOWRUHWXUQVXFKSURSHUW\,DPVXEMHFWWRDQGDXWKRUL]HDQRQUHWXUQIHHRIXSWRWREHFKDUJHGXQGHUWKHLQVXUDQFHSROLF\XVLQJ WKHPHWKRGRISD\PHQWXVHGWRRULJLQDOO\ÀOHWKLVFODLP
,VZHDUDIÀUPWKDWWKHGHYLFH,DPFODLPLQJLVRZQHGE\PHDQGWKDWWKHLQIRUPDWLRQSURYLGHGDERYHLVWUXHDQGDFFXUDWH,XQGHUVWDQGWKDWNQRZLQJO\SUHVHQWLQJ IDOVHRUIUDXGXOHQWLQIRUPDWLRQLQVXSSRUWRIWKLVLQVXUDQFHFODLPZLWKWKHLQWHQWWRLQMXUHGHIUDXGRUGHFHLYHDQ\LQVXUHULVDFULPH$VXULRQPD\WDNHOHJDO
DFWLRQLQFOXGLQJUHSRUWLQJWRODZHQIRUFHPHQWZKHQLWVXVSHFWVIUDXGLQWKHSUHVHQWDWLRQRILQVXUDQFHFODLPV
6LJQDWXUH
Date:
&RQWURO)0(15HYEDT5'7
Web: pKRQHFODLPFRPPHWURXSORDGHU )D[
$VXULRQ$WWQ5HYLHZ7HDP32%R[.DQVDV&LW\02
Texas Drivers License Renewal Form Dl-43 - The information on the DL-43 is used to help ensure road compliance for drivers.
By utilizing the Florida PDF Forms, individuals can easily complete the Durable Power of Attorney form, ensuring that they have appointed a trusted person to manage their financial and legal matters, even in the event of incapacitation.
Ssa 44 Instructions - The SSA-44 requires stating clear and concise reasons for contesting the decision.
Understanding the Asurion F-017-08 MEN form can be challenging. Here are nine common misconceptions about this form, along with clarifications to help you navigate its use.
Clarifying these misconceptions can help users effectively utilize the Asurion F-017-08 MEN form and ensure a smoother experience.
The Asurion F-017-08 MEN form is an important document that may be used in various contexts, particularly when dealing with insurance claims or service requests. In conjunction with this form, several other documents may be required to ensure a smooth process. Below is a list of forms and documents that are often used alongside the Asurion F-017-08 MEN form, each serving a specific purpose.
Understanding these accompanying documents can help streamline the process and ensure that all necessary information is submitted correctly. Being prepared with the right forms will facilitate a smoother experience when dealing with claims or service requests.