IF YOU HAVE QUESTIONS ABOUT THE CLAIMS PROCESS YOU ARE STRONGLY ENCOURAGED TO CONTACT THE TRUST PRIOR TO ABATEMENT OF THE VERMICULITE

U.S. ZAI Claim Form Instructions

Click here to view video instructions on how to fill out the claim form.

Instructions for completing the U.S. Zonolite Attic Insulation ("ZAI") Claim Form are listed below. In order to submit a claim for reimbursement from the U.S. ZAI Trust, you will need to establish three things:

1. Production Identification. - You must establish that ZAI is, or was, installed in the structure. See FAQ 27.

2. Expenditures. - You must provide documents showing that you spent funds to remove, abate or contain the ZAI.

3. Declaration of Ownership. - You must show that you owned or were a tenant in the structure that contained ZAI.

Instructions for completing the Claim Form are listed below. For a complete explanation of how the U.S. ZAI Trust will operate, please review the ZAI Trust Distribution Procedures.  ZAI Trust Distribution Procedures.

You can start your claim here

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Part Information Requested Explanation

1     CONTACT INFORMATION.

Please provide the name of the individual making the claim and your current contact information. If your contact information changes before your claim is processed, please provide the ZAI Trust with updated contact information.

2     PROPERTY INFORMATION.

Property Address

Please provide the address of the property that contains or contained the Zonolite Attic Insulation.

Structure Type

Provide the best description possible of the type ofstructure that contains or contained ZAI. Examples of structure types include: residence, cabin, garage, apartment, duplex, commercial building, or outbuilding.

Date Built

Provide the approximate date the structure was built. If you do not know when the structure was built and have no way of obtaining that information, put “unknown.”

ZAI Location

List where in the structure the ZAI is located. Examples of locations where ZAI is commonly found in a structure include attic or walls.

Date ZAI was installed

List the approximate date the ZAI was installed, if known. If you do not know, put “ unknown” on that line.

Date ZAI was removed

List the approximate date the ZAI was removed from the structure.

3     PRODUCT IDENTIFICATION. You need only provide one of the items listed below.

General Instructions

The product identification requirements depend upon whether the ZAI was abated prior to or after 6/16/2014. Items 1-3 may be used by all claimants as a form of Product Identification. Items 4-7 may only be used by claimants who had the ZAI removed prior to 6/16/14.

1

ZAI Sample

You may provide a sample of the ZAI. If you do so, you must include a declaration signed by you or a contractor that the insulation came from the structure in question. You should include approximately 3 ounces of the material. Be sure to follow the instructions that are included in your Claim Packet when taking the sample.

2

ZAI Bag

The original ZAI bag that contained the vermiculite, portion of a ZAI bag, or photograph of a ZAI bag in the structure may be provided as Product Identification. In addition, you must also provide a declaration from the homeowner or abatement contractor confirming that the bag was found in the structure's attic or other area in question.

3

Receipt or Invoice

A receipt or invoice reflecting the purchase of ZAI for the structure can be provided as Product Identification.

4

Before and after photographs

You may provide before and after photographs of the attic or other areas in question depicting the presence of the attic insulation and removal of ZAI. You must also provide a declaration by the homeowner or contractor verifying that the material depicted in the photographs was vermiculite that was present in the structure.

5

Contractor Certification

You may provide a certification that vermiculite attic insulation was present in the structure, attested to by a licensed or certified asbestos abatement contractor who removed vermiculite from the structure.

6

Laboratory Report

A laboratory report showing the prescence of asbestos in a vermiculite sample taken from the structure can be provided as Product Identification.

7

Declaration of Installation

If you filed a timely US ZAI Proof of Claim with the Bankruptcy Court (filing deadline was 10/31/2008) and have direct personal knowledge of the events surrounding the installation of ZAI in the structure, you may provide a Declaration. The Declaration should include the following (1) that ZAI was installed in the structure; and (2) stating facts establishing your direct personal knowledge.

4     FUNDS EXPENDED.

4a

If you paid for the ZAI to be removed, abated, or contained from the structure, please list the date paid, amount paid, name of the removal contractor or abatement company and attach the following documents:

  1. A copy of the invoices or contracts for abatement and/or reinsulation AND
  2. Documentation evidencing payment (e.g. cancelled check, credit card statement, bank statement, or other) See FAQ #16
  3. Cash payments will be subject to a heightened level of scrutiny, including cooperation by the abatement contractor. See FAQ #16
  4. If you choose to have the reimbursement sent directly to the contractor, skip Part A and move on to Part B.
  5. * Labor costs for Do-it-Yourself ("DIY") removals are not reimburseable.THE EPA STRONGLY RECOMMENDS USING ONLY A LICENSED ASBESTOS ABATEMENT CONTRACTOR FOR REMOVAL.

4b

If you have authorized payment by the Trust to be made directly to the contractor who removed, abated, or contained the ZAI, please provide the name and address of the removal contractor or abatement company and attach the following documents:

  1. A copy of the invoice or contract; AND
  2. Documentation evidencing any partial payment; AND (See FAQ #11 and #16)
  3. Certification from the contractor that the work reflected in the contract was performed to completion.

5     OWNERSHIP DECLARATION.

Ownership Interest

Please check whether you own or rent the structure with the ZAI

Date and Sign

Please review the Claim Form and sign under penalty of perjury that the information provided in the Claim Form, including the evidence attached, is true and correct to the best of your knowledge.

By submitting your claim and supporting documentation you authorize the ZAI Trust to contact any of your service providers to verify the accuracy and authenticity of the documentation that you submit.

I, the undersigned, hereby declare under penalty of perjury that all the information provided in this US ZAI Proof of Claim Form, including all evidence attached, is true and correct to the best of my knowledge and belief.

I understand that providing false information, whether by me or someone acting on my behalf, may constitute a criminal offense and may be grounds for denying the claim in its entirety. Further, I understand that the Trustee is obligated to notify the Bankruptcy Court of any payments made as a result of fraudulent conduct on the part of a contractor, claimant, or other person.

MAIL

Please submit the Claim Form and all requested documents to the ZAI Trust at the following address:

ZAI TRUST

317 Wingo Way

Suite 303

Mt. Pleasant, SC 29464