Reimbursement Forms

Funeral Directors:

Below are the reimbursement forms that will be required.   There is one form for Guaranteed Contracts, and one form for Non-Guaranteed Contracts.  You can obtain the forms by clicking on the links below.  Otherwise, Fiduciary Partners or the Receiver can provide them to you.

Reimbursement – Guaranteed

Reimbursement – Non-Guaranteed

As noted in the instructions to the reimbursement forms, each form must be submitted to Fiduciary Partners along with a death certificate or Affidavit of Death of the depositor, and a copy of the funeral bill (the Statement of Goods and Services).

Forms for other transactions with the Trust can be obtained from Fiduciary Partners.

Fiduciary Partners, Inc.
Attention: WFT
3913 West Prospect Avenue, Suite 201
Appleton, Wisconsin 54914
Toll Free: 866-380-9969
Fax: 920-380-9961

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