To help ensure the security of your handset insurance claim and identification, on occasion, we will need
additional information.

If you have been asked to provide us with some additional information, we need you to complete the form and fax it
to us along with the requested identification. Please click on the link below and print the form.

Para la version en espanol, haga clic aqui

Questions about the affidavit? Click here for help

What Type of Identification Do We Need?
All forms of identification must be legible, unaltered, and legitimate. (Don’t draw a mustache on your picture!) If the
ID appears altered, forged or not legitimate, we have to get an Asurion Insurance Adjuster to review the claim in its
entirety (really slows things down).

Any of the following United States Government issued IDs or a recognized United States educational institution ID
is an acceptable form of identification.
1. Valid Driver’s license or Identification Card
2. Passport issued by any Government.
3. Visa (green card or alien card)
4. Military ID

Don’t change names on us! If the name on the Identification does not match the name of the person filing the
claim and name on the wireless carrier account, then additional information may be required (again, unfortunately
slows things down)

How to Return the Form?
Quick Option : Fax the form to Asurion at 1-877-595-1399

Slow Option : Mail the form and copy of your valid ID to the following address:
Asurion Attn: Claims Documentation Processing
648 Grassmere Park, Ste. 200
Nashville, TN 37211

After your Claim Affidavit form has been received and processed, a Customer Service Representative will contact
to complete your claim. You simply come back here – type in your claim number and you are on the fast track to
completion!