Form TR-95A Unpaid Insurance Claim Affidavit - Kansas

Form TR-95A Unpaid Insurance Claim Affidavit - Kansas

What Is Form TR-95A?

This is a legal form that was released by the Kansas Department of Revenue - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form TR-95A?A: Form TR-95A is an Unpaid Insurance Claim Affidavit.

Q: What is the purpose of Form TR-95A?A: The purpose of Form TR-95A is to provide a sworn statement regarding an unpaid insurance claim.

Q: Who needs to fill out Form TR-95A?A: Anyone who has an unpaid insurance claim in Kansas may need to fill out Form TR-95A.

Q: What information is required on Form TR-95A?A: Form TR-95A requires information such as policy details, the amount claimed, and the reasons why the claim has not been paid.

Q: Is there a deadline for submitting Form TR-95A?A: Yes, there is typically a deadline for submitting Form TR-95A. It is important to check with the Kansas Insurance Department or your insurance company for specific deadlines.

Q: What should I do after filling out Form TR-95A?A: After filling out Form TR-95A, you should submit it to the Kansas Insurance Department or your insurance company as instructed.

Q: What happens after submitting Form TR-95A?A: Once Form TR-95A is submitted, the Kansas Insurance Department or your insurance company will review the information and determine the appropriate course of action.

Q: Is there a fee to submit Form TR-95A?A: No, there is no fee to submit Form TR-95A.

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Form Details:

  • Released on May 1, 2021;
  • The latest edition provided by the Kansas Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form TR-95A by clicking the link below or browse more documents and templates provided by the Kansas Department of Revenue.

Download Form TR-95A Unpaid Insurance Claim Affidavit - Kansas

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