This option allows you to download a copy of the blank Questionnaire and complete the Questionnaire offline. Once you complete the Questionnaire, this Portal will allow you to upload your completed Questionnaire and submit it electronically, along with the documents that must be provided with the Questionnaire submission.
The below Basic Information allows the Portal to track the documents you upload. You must provide this information in addition to the information requested in Parts 2, 3, and 4 of the Questionnaire.
If you represent multiple claimants, you must complete a separate Questionnaire for each claimant and separately upload the required attachments.
Upload your completed Questionnaire here, along with any additional Questionnaire pages you used to complete your responses. Your Questionnaire should be a single PDF file containing 56 pages; there should be no additional pages or supporting documents merged onto the PDF.
Any additional pages/PDFs used to complete your response must be uploaded as separate files. For example, if you included additional related claimants as part of supplementing Part 3 of the Questionnaire, please upload two files: the completed, 56-page Questionnaire and the additional Part 3 file. If you chose to sign the Claimants’ Optional Authorization For Debtors’ Counsel to Obtain Trust Records (included in the Questionnaire as Exhibit 1) separately from the main Questionnaire, please also upload that signed form here.
In the following step, you will upload the required attachments to the Questionnaire, as well as any documents wish to attach to answer Parts 6, 7, and 8 of the Questionnaire as listed in your Aldrich/Murray Personal Injury Questionnaire Document Checklist Summary Inventory.
ALDRICH & MURRAY
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Upload the following (please use PDF format if possible):
- Questionnaire (required)
- Questionnaire Additional Pages (optional)
Each claimant must submit copies of all Trust claim forms submitted by or on behalf of the claimant or Injured Party to Trusts listed in Table B of the Questionnaire (or the electronic equivalent if submitted electronically), as well as all other documents submitted to the Trusts, such as deposition transcripts, affidavits, invoices, etc. Alternatively, the claimant may execute the authorization included in the Questionnaire as Exhibit 1 to authorize a law firm representing Aldrich and Murray to obtain from Trusts any claim forms submitted to a Trust by or on behalf of the claimant or Injured Party, as well as other documents claimants submitted to the Trusts.
In addition, each claimant must upload copies of the following documents in the possession, custody, or control or the claimant or the claimant’s counsel:
- All depositions that are in the Mesothelioma Claimant’s or his/her attorney’s possession taken in any lawsuits listed in Part 8A that relate in any way to the Injured Party's alleged exposures to asbestos or asbestoscontaining products;
- All written discovery (including interrogatories and requests for admission) that are in the Mesothelioma Claimant’s or his/her attorney’s possession answered on behalf of the Injured Party or Related Claimant in any of the lawsuits listed in Part 8A;
- All expert reports that are in the Mesothelioma Claimant’s or his/her attorney’s possession produced by any party in a lawsuit listed in Part 8A;
- Social Security printout and copy of union or employment records relevant to the Injured Party's asbestos exposure (where available) that are in the Mesothelioma Claimant’s or his/her attorney’s possession. In the case of alleged Secondary or Household exposure, provide the Social Security printout and copy of union or employment of the person who worked with or around asbestos or asbestos-containing products who brought home asbestos fibers on his or her clothes (i.e., the Primary Exposed Person); and
- Copy of medical records (or autopsy report) confirming diagnosis of mesothelioma: at least one report from a qualified physician with information regarding the Injured Party's diagnosis. Mesothelioma Claimants may submit additional documentation, such as x-rays, lab tests and medical exam reports. The submitted evidence should comply with recognized medical standards regarding testing methods, equipment and procedures. A death certificate must be accompanied by pathology or autopsy findings. In addition, the diagnosis must include a pathology or operative report that indicates a diagnosis of mesothelioma.
Then, please confirm you have submitted all documents listed in your Aldrich/Murray Personal Injury Questionnaire Document Checklist Summary Inventory.
ALDRICH & MURRAY
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Documents uploaded here will only be considered part of the submission for the claimant indicated on the "Basic Information" screen. Documents applicable to multiple claimants should be uploaded in the submission for each claimant.
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