Section 3 - Statement of Claim for Reimbursement3.1 All claims for reimbursement must be submitted in a format designated by the administrator.3.2 The statement of claim must include, at a minimum, the following information: 3.2.1 The name and address of the lawyer alleged to have engaged in dishonest conduct;3.2.2 The amount of the alleged loss;3.2.3 The date or period of time during which the alleged loss occurred;3.2.4 A general statement of facts relative to the claim, including a statement regarding efforts to collect any judgment against the lawyer;3.2.5 The name and address of the claimant and a verification of the claim by the claimant under oath; and3.2.6 The name of the attorney, if any, who is assisting the claimant in presenting the claim to the Committee.3.3 The statement of claim must contain substantially the following statement: "ALL DECISIONS REGARDING PAYMENTS FROM THE CLIENT SECURITY FUND ARE DISCRETIONARY. Neither the Oregon State Bar nor the Client Security Fund are responsible for the acts of individual lawyers."Revised Effective 1/1/2022.