Your Claim Documents

Please follow the three easy steps below to complete and submit your affidavit.

Easy as 1, 2, 3

  1. Print the form by clicking the "Get Affidavit" tab or click "Next".
  2. Complete all sections of the affidavit. Don't forget to sign and date the form!
  3. Return your documents to Asurion using the Upload, Fax or Mail option.

We apologize for any delay this causes in your claims process, but the security of your account is very important to us!

You can obtain your affidavit by entering your phone number, Claim ID and clicking the Get Affidavit button.

Phone Number
Claim ID

Don't know your Claim ID? Click here to get an affidavit.

Complete Affidavit

What you will need to complete your affidavit.

  • Follow the instructions and complete all sections of the affidavit. Be sure to sign the affidavit!
  • Attach a copy of a valid ID.

    Acceptable Forms of IDNonacceptable Forms of ID
    1. Valid Driver's License1. Student IDs
    2. US or Foreign Passport2. Work IDs
    3. Military ID (Active or Retired)3. Birth Certificates
    4. State or Federally Issued ID Card4. Social Security Cards
    5. Matricula Consular ID

    The name on the ID must match the name of the primary account holder. If the name does not match, then additional documentation may be required. Increasing the size and lightening the ID before submitting assists with the review of your documents, and helps prevent delays in claim processing.

    All forms of identification must be legible, unaltered and legitimate. The ID also cannot be expired. If the ID appears altered, forged, or not legitimate, we will not be able to process your claim.

  • Need more information?

How to submit your affidavit.

To upload your completed affidavit & ID, please click upload.

Once we receive your documents, we will review them and contact you regarding next steps within 24 hours via email or automated voice message.

If you are having difficulty using the uploader, you may submit your affidavit by faxing to Asurion at 1-800-317-2296, or by mail using the following address:

Asurion Attn: Review Team (nTelos)
P.O. Box 413886
Kansas City, MO 64141-3886