Please complete one of the forms below and submit it online to the Risk Management Office as directed on the form. Clicking on the links will take you to information such as claims filing instructions, printable forms, and examples of certain required documentation.Medicare coverage starts based on when you sign up and which sign-up period, you're in: Generally, when you turn 65. These sample letters can be used in various circumstances you may encounter that require you to communicate with insurance companies. A LOMR is a letter from FEMA officially revising the current NFIP map to show changes to floodplains, regulatory floodways, or flood elevations. A pricing worksheet is provided in Form B to assist you. Insurance. The Division will then send out a FS-5 letter "Notification of Termination of Liability Insurance. Coverage". If you do not want your student to participate, then please complete this parent opt-out form and return it to any Charlotte Mecklenburg Library branch. If you do not want your student to participate, then please complete this parent opt-out form and return it to any Charlotte Mecklenburg Library branch. Complete Form MVR4A properly signing in the presence of a notary.