Aflac Initial Disability Claim Form S00224

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SICKNESS CLAIM FORM - District Home
LAST NAME FIRST NAME MIDDLE INITIAL American Family Life Assurance Company of Columbus (Aflac) SICKNESS CLAIM FORM– EMPLOYER'S DISABILITY STATEMENT Failure to complete this form in its entirety may result in a delay in processing this claim. ... Access Content

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Initial. below for optional services. Any other marks used (check mark, x, etc.) *DISABILITY • If you are claiming disability, I have checked the answers on this claim form and they are correct. ... Return Doc

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Aflac Initial Disability Claim Form S00224 Employers Statement
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SHORT TERM DISABILITY CLAIM FORM INSTRUCTIONS
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