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Still Have Questions? Contact Us

Denise Verona

Denise Verona
Arbitration Manager

Telephone: 317.876.4262
Fax: 317.415.0803

Instructions for using the PDF fill in form.

To Fill Out the Form in Adobe Acrobat Reader:

Open the form using the Adobe Acrobat Reader plugin for your browser.

Select the hand tool.

Position the pointer inside a form field and click. The I- beam pointer allows you to type text. The arrow pointer allows you to select a field, a check box, a radio button, or an item from a list.

After entering text or selecting an item, check box, or radio button, do one of the following:

  • Press Tab to accept the field change and go to the next field. Press Shift+ Tab to accept the field change and go to the previous field.
  • Press Enter or Return to accept the field change and deselect the current field.

Note: In a multiline text field, Enter/ Return goes to the next line in the same field. In Windows, you can use the Enter key on the keypad to accept a change and deselect the current field.

Press the Escape key to reject the field change and deselect the current field.

Note: Pressing Escape a second time when you are in Full Screen mode causes you to exit Full Sceen mode.

Once you have filled in the appropriate fields, print the form (using the Printer Icon inside Adobe Acrobat Reader). Mail the form to us at the address indicated on the form.

To clear a form in a browser window:

  • Exit the Acrobat viewer and start again.

Posted: Thursday, January 24, 2013 3:28:04 PM. Modified: Thursday, January 24, 2013 3:28:40 PM.

NAMIC Arbitration Service Partners

Paragon Latitude Subrogation Services National Subrogation Servcies, LLC Wilber Law Firm, PC AFNI Thomas George Associates, Ltd. Client Services Incorporated DKA, inc. A Subrogation Company Wilber AnSR SDI

317.875.5250 - Indianapolis  |  202.628.1558 - Washington, D.C.

NAMIC | Where the future of insurance has its voice TM