jump to main menu jump to subject menu jump to content jump to footer
go image

Division Director

Sha'Ron James

Assistant Director

Al Willis


Division of Rehabilitation and Liquidation
Alexander Bldg.,
2020 Capital Circle SE, Ste. 310
Tallahassee, FL 32301
1-800-882-3054
design placeholder only

Proof of Claim Form for Alabama, Georgia and Tennessee Claimants Only

Alabama, Georgia and Tennessee claimants should complete this form on-line, print the form and mail it to the Receiver at: National Title Insurance Company in Receivership, 2020 Capital Circle SE, Suite 310, Tallahassee, FL 32301. The deadline for submitting claims is July 13, 2013. No claims will be considered after this date. The Claim Filing Deadline for Alabama, Georgia and Tennessee claimants does not apply to Florida claimants.

adobeThe following documents are provided as Adobe Acrobat PDF files and require the free Adobe Acrobat reader software
(you are leaving the DFS website and opening a new browser window)

Alabama, Georgia and Tennessee claimants click here to complete a claim form.