Claims

Registration is now open

Deadline March 29, 2021

Settlement Claim Instructions

When Claims forms become available, please read through these instructions.
 

Flint Water Settlement Categories

Claims forms will require different information depending on the Settlement Category under which you are claiming recovery. See this document for explanations of the 30 categories.


 

Submitting a Claim on Someone Else's Behalf?

See the chart below for the necessary documentation establishing your legal authority.
 

Documentation to support claim to funds

Personal Injury Proof of Exposure for Settlement Categories

The following Forms of Documentation can be used to prove exposure to Flint water for the Personal Injury Categories 1 through 27:

 

Required: Declaration Form – form stating that the Claimant dwelled, resided, lived, worked, attended school or day care, or was exposed to water, in Flint along with addresses and time periods for each address where Claimant lived and was exposed to Flint water for at least 21 days during any 30-day period between the relevant dates in the various Categories 1 - 26, and for any number of days between the relevant dates for Category 27.

 

All Claimants asserting claims under Categories 1 - 27 must complete and return this form along with at least one of the supporting documents listed below:

  • Water bill in the Claimant’s name during the relevant category Exposure Period for property where Claimant was exposed to Flint water; OR

  • School Record during the relevant category Exposure Period with Minor child’s name and address (showing Flint address of school and/or Claimant); OR

  • Day Care Invoice during the relevant category Exposure Period with Minor child’s name and address (showing Flint address of day care location and/or Claimant); OR

  • Letter from employer verifying employment during the relevant category Exposure Period at business in Flint with address (showing Flint address of place of employment and/or employee); OR

  • Check or pay stub during the relevant category Exposure Period with the Claimant’s name showing Flint address of place of employment and/or employee; OR

  • Tax return during the relevant category Exposure Period showing address in Flint and name of Claimant on return; OR

  • Deed to property located in Flint during the relevant category Exposure Period showing name of Claimant on deed; OR

  • Lease during the relevant category Exposure Period for residential property in Flint listing Claimant in lease; OR

  • Mortgage Statement for residential property in Flint during the relevant category Exposure Period showing name of Claimant on statement; OR

  • Other document sufficient to reliably show address of Claimant’s exposure to Flint water during the relevant category Exposure Period. The Claims Administrator will follow up with you if necessary after their review of the documentation provided.

 

 

Property Owners/Renters (which includes those who paid water bills), or for Business Owners - Categories 28 through 30

The following Forms of Documentation can be used to prove exposure to Flint water for Property Owners/Renters (which includes those who paid water bills), or for Business Owners - Categories 28 through 30 (the documentation must be dated during the time period from April 25, 2014 through July 31, 2016 – only one document needs to submitted):

  • Water bill for property – needs to be in name or business name of Claimant; OR

  • Tax return – needs to show property address AND be in name or business name of Claimant; OR

  • Deed to property – needs to be in name or business name of Claimant; OR

  • Lease – needs to be in name or business name of Claimant; OR

  • Mortgage Statement – needs to be in name or business name of Claimant.

 

Submitting a Claim on Someone Else's Behalf?

See the chart below for the necessary documentation establishing your legal authority.

© 2021 Flint Water Justice

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