To file a proof of claim electronically, please enter the creditor’s name and an email address (where filing confirmation will be sent) in the fields below. Please note that supporting documentation is limited to a single PDF attachment that is less than 5 megabytes in size and under 100 pages
Patriot National, Inc.
Case No. 18-10189
Submit a Claim
IN THIS CASE, PROOFS OF CLAIM MAY BE FILED EITHER ELECTRONICALLY VIA THIS WEBSITE OR BY HARD COPY PRIOR TO THE BAR DATE WHICH IS THE DEADLINE ESTABLISHED BY THE BANKRUPTCY COURT.
FILE A CLAIM ELECTRONICALLY
If submitted electronically using the interface above, additional hard-copy submission is not necessary. Please note that submission of claim forms via email and/or facsimile transmission is not permitted.
FILE A CLAIM VIA MAIL
Completed proof of claim forms should be sent to the following address:
Patriot National, Inc. Claims Processing Center
c/o Prime Clerk LLC (now known as Kroll Restructuring Administration)
Grand Central Station
PO Box 4850
New York, NY 10163-4850
T: (855) 631-5360
Please click here to download the Proof of Claim form.
Please file proof(s) of claim, if any, via US Mail or other hand delivery system. Submission of claim forms via email and/or facsimile transmission is not permitted. You must file an originally executed proof of claim. If you would like a copy of your claim returned to you as proof of receipt, please enclose an additional copy and a self-addressed postage-paid envelope.
Privacy of Information Collected
The information requested on the proof of claim form is being collected for the purposes of facilitating a debtor’s voluntary petition for relief under the U.S. Bankruptcy Code and processing any claim you may have against the Debtors. Your proof of claim form must not contain medical records, complete social security numbers or tax identification numbers (only provide the last four digits), a complete birth date (only provide the year), the name of a minor (only provide the minor's initials) or a financial account number (only provide the last four digits of such financial account).
PLEASE REVIEW YOUR PROOF OF CLAIM AND SUPPORTING DOCUMENTS AND REDACT ACCORDINGLY PRIOR TO UPLOADING THEM. PROOFS OF CLAIM AND ATTACHMENTS ARE PUBLIC DOCUMENTS THAT WILL BE AVAILABLE FOR ANYONE TO VIEW ONLINE.
The information you provide on the proof of claim form will be retained by or on behalf of the Bankruptcy Court, the debtor and Kroll Restructuring Administration (formerly known as Prime Clerk) for as long as necessary for the purposes described above, as needed to resolve disputes or protect legal rights as they relate to such claim, or as otherwise required by law. Some or all of the information you provide on the proof of claim form will be displayed and/or accessible on the debtor’s case website hosted by Kroll Restructuring Administration pursuant to applicable law and/or court order. Additionally, such information may be shared with certain third parties affiliated with this matter in furtherance of the bankruptcy case and process. Although you may have certain rights relating to the information provided on the proof of claim form under certain laws, applicable law or court order may prohibit the amendment or erasure of such information once it is submitted, including information displayed and/or accessible at the case website.