Thank you for choosing Remedy Check Protection™. Remember, when filing a reimbursement request you will need to supply a copy of your bank statement, the Reimbursement Request Form and the Limited Durable Power of Attorney Form. You must also include any and all documents related to the loss, including the original check upon which the request is based, police reports or any other documentation related to the loss.

For your convenience, we've provided a "one click" download that include both forms. Click here to download the forms in PDF Format (requires Acrobat Reader).

If you would prefer to complete your forms online, Click here to access our automated form generator. This form will collect all pertinent information and generate both forms for you to print.