You are now beginning an official Application for Benefits. You may choose Save at any time to finish the application later, but you must finish this application by hitting the “SUBMIT” button on the final page by the application deadline specified in the fund protocol.
If you do not see a screen confirmation message and receive an e-mail message confirming that you have completed the application, you have not formally submitted the application and are not yet eligible for benefits.
Fields marked with a * are required.
refers to the person completing this application.
refers to the person(s) who was physically injured as a result of the collapse, present in Champlain Towers South at the time of the collapse, or displaced residents of Champlain Towers South who were not present at the time of the collapse.
refers to the legal representative of the victim.
The rules for how these funds are to be distributed is governed by the Final Protocol which is available online at: