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					                   EXHIBIT A




RLF1 3618150v. 1
                                                          SPHC Claim Estimation Form




PART 1: INJURED PARTY INFORMATION

Last Name:                                                    First Name:                                  Middle Initial:   Suffix:

Social Security Number:                                       Foreign Tax ID:                              Date of Birth:

Mailing or Street Address

City of Residence                            State of Residence              Zip Code                    Country (if outside the US)


PART 2: RELATED CLAIMANT INFORMATION (if different than INJURED PARTY)

Related Claimant: a person who is not the allegedly exposed person but who is making a claim either in a representative capacity (e.g. Personal
Representative of an estate), or an independent capacity (e.g. wrongful death) that is based on the injuries to the allegedly injured Claimant
Last Name:                                                    First Name:                                  Middle Initial:   Suffix:

Social Security Number                                        Foreign Tax ID:                              Date of Birth:

Mailing or Street Address:

City of Residence                            State of Residence              Zip Code                    Country (if outside the US)


PART 3: LAW FIRM/ATTORNEY INFORMATION (or other legal representative)

Name of Firm:

Last Name of Lawyer:                                          First Name of Lawyer                         Middle Initial:   Suffix:

Firm Mailing or Street Address:

Firm City                                    Firm State                          Zip Code                  Phone No.: (Area Code) ###-####

Name of Firm Administrative Contact:                                             Email Address




                                                                    Page 1 of 13
                                                         SPHC Claim Estimation Form


PART 4: ALLEGED INJURY

INSTRUCTIONS: Check all that apply
If injured party is DECEASED:       Date of Death: (mm/dd/yyyy):              Was autopsy performed? (Y/N)          Was death asbestos-related? (Y/N)


    Mesothelioma                                                                 Lung cancer
Date of diagnosis of this condition (mm/dd/yyyy): _____________               Date of diagnosis of this condition (mm/dd/yyyy): _____________
Name of doctor making first diagnosis (fill in blank)                         Name of doctor making first diagnosis (fill in blank)
___________________________________________________                           ___________________________________________________
What is your relationship to the health care provider making the diagnosis?   What is your relationship to the health care provider making the diagnosis?
(check all that apply):                                                       (check all that apply):
   Treating physician seen in the ordinary course of treatment                   Treating physician seen in the ordinary course of treatment
   Consultant referred by an attorney other than your primary attorney           Consultant referred by an attorney other than your primary attorney
   Consultant referred by your attorney                                          Consultant referred by your attorney
   Consultant obtained through a screening program                               Consultant obtained through a screening program


   Asbestosis                                                                    Laryngeal cancer
Date of diagnosis of this condition (mm/dd/yyyy): ____________                Date of diagnosis of this condition (mm/dd/yyyy): _____________
Name of doctor making first diagnosis (fill in blank)                         Name of doctor making first diagnosis (fill in blank)
__________________________________________________                            ___________________________________________________
What is your relationship to the health care provider making the diagnosis?   What is your relationship to the health care provider making the diagnosis?
(check all that apply):                                                       (check all that apply):
   Treating physician seen in the ordinary course of treatment                   Treating physician seen in the ordinary course of treatment
   Consultant referred by an attorney other than your primary attorney           Consultant referred by an attorney other than your primary attorney
   Consultant referred by your attorney                                          Consultant referred by your attorney
   Consultant obtained through a screening program                               Consultant obtained through a screening program



   Digestive tract cancer                                                        Kidney cancer
Date of diagnosis of this condition (mm/dd/yyyy): _____________               Date of diagnosis of this condition (mm/dd/yyyy): _____________
Name of doctor making first diagnosis (fill in blank):                        Name of doctor making first diagnosis (fill in blank):
__________________________________________________                            ___________________________________________________
What is your relationship to the health care provider making the diagnosis?   What is your relationship to the health care provider making the diagnosis?
(check all that apply):                                                       (check all that apply):
   Treating physician seen in the ordinary course of treatment                   Treating physician seen in the ordinary course of treatment
   Consultant referred by an attorney other than your primary attorney           Consultant referred by an attorney other than your primary attorney
   Consultant referred by your attorney                                          Consultant referred by your attorney
   Consultant obtained through a screening program                               Consultant obtained through a screening program


   Other alleged asbestos-related malignant condition                            Other alleged asbestos-related non- malignant condition
Name of Condition: ____________________________________                       Name of Condition: ____________________________________

Date of diagnosis of this condition (mm/dd/yyyy): _____________               Date of diagnosis of this condition (mm/dd/yyyy): _____________
Name of doctor making first diagnosis (fill in blank):                        Name of doctor making first diagnosis (fill in blank):
____________________________________________________                          ____________________________________________________
What is your relationship to the health care provider making the diagnosis?   What is your relationship to the health care provider making the diagnosis?
(check all that apply):                                                       (check all that apply):
   Treating physician seen in the ordinary course of treatment                   Treating physician seen in the ordinary course of treatment
   Consultant referred by an attorney other than your primary attorney           Consultant referred by an attorney other than your primary attorney
   Consultant referred by your attorney                                          Consultant referred by your attorney
   Consultant obtained through a screening program                               Consultant obtained through a screening program




                                                                     Page 2 of 13
                                                         SPHC Claim Estimation Form



PART 5: SMOKING HISTORY

What is the tobacco usage history of the Primary Claimant?
Are you, or have you ever, smoked cigarettes? (Y/N): _________________________
If Yes, Please complete the following
     Age at onset of smoking: __________________________
     Age at quitting smoking (if still smoking or if smoking when deceased, use current age or age at death, as appropriate): ____________________


Brand(s) of cigarettes smoked (check all that apply):

    Ace                       Chesterfield        L&M                   More                      Philip Morris          Virginia Slims
    American Spirit           Doral               Lark                  Nat Sherman               Players                Winston
    Basic                     Eve                 Lucky Strike          Newport                   Salem                  TRUE
    Benson & Hedges           Gold Coast          Marlboro              Now                       Satin                  Rolled your own
    Black & Gold              Grand Prix          Maverick              Old Gold                  Tareyton               Non-US Brands
    Camels                    Kent                Max                   Pall Mall                 Vantage                Other
    Carlton                   Kool                Monarch               Parliament                Viceroy


Highest packs-per-day usage (check box below):                                  Average packs-per-day usage (check box below):
   Less than 1 pack-per-day                                                          Less than 1 pack-per-day
   1 pack-per-day                                                                    1 pack-per-day
   1.5 packs-per-day                                                                 1.5 packs-per-day
   More than 2 packs-per-day                                                         More than 2 packs-per-day

Have you ever used tobacco in any other form? (check all that apply):
   Pipe (during what period of time)                                                 Chewing tobacco (during what period of time)
            (yyyy) to (yyyy): ___________ to _____________                                 (yyyy) to (yyyy): ____________ to ____________
   Cigars (during what period of time)                                               Other (during what period of time
            (yyyy) to (yyyy): ___________ to _____________                                 (yyyy) to (yyyy): ______________ to _____________
   Snuff (during what period of time)
            (yyyy) to (yyyy): ___________ to _____________




                                                                    Page 3 of 13
                                                           SPHC Claim Estimation Form


PART 6: ALLEGED EXPOSURE

INSTRUCTIONS: Use these Product, Occupation, and Industry codes when completing PART 6 for ALLEGED EXPOSURE (see next page)

                                                              Bondex/RPM Product Codes

P-01   SX Joint Cement Powder                                                 P-09 Multi-Patch
P-02   All Purpose Joint Compound                                             P-10 Penncraft All Purpose Joint Cement Powder
P-03   Ready Mixed (Premixed) Joint Cement                                    P-11 Penncraft Ready Mixed Joint Cement
P-04   Water Putty                                                            P-12 Penncraft Water Putty
P-05   Dramex Texture Paint (powder)                                          P-13 Penncraft Texture Paint Powder
P-06   Dramex Texture Paint (premix)                                          P-14 Wards Ready Mixed Joint Cement
P-07   Block Filler                                                           P-15 Wards Joint Cement Powder
P-08   Block Primer                                                           P-16 Other
                                                                      Occupation Codes

O-01   Air conditioning and heating installer/maintenance                     O-31 Iron worker
O-02   Asbestos miner                                                         O-32 Joiner
O-03   Asbestos plant worker/asbestos manufacturing worker                    O-33 Laborer
O-04   Asbestos removal/abatement                                             O-34 Longshoreman
O-05   Asbestos sprayer/spray gun mechanic                                    O-35 Machinist/machine operator
O-06   Assembly line/factory/plant worker                                     O-36 Millwright/mill worker
O-07   Auto mechanic/bodywork/brake repairman                                 O-37 Mixer/bagger
O-08   Boilermaker                                                            O-38 Non-asbestos miner
O-09   Boiler repairman                                                       O-39 Non-occupational/residential
O-10   Boiler worker/cleaner/inspector/engineer/installer                     O-40 Painter
O-11   Building maintenance/building superintendent                           O-41 Pipefitter
O-12   Brake manufacturer/installer                                           O-42 Plasterer
O-13   Brick mason/layer/hod carrier                                          O-43 Plumber - install/repair
O-14   Burner operator                                                        O-44 Power plant operator
O-15   Carpenter/woodworker/cabinetmaker                                      O-45 Professional (e.g., accountant, architect, physician)
O-16   Chipper                                                                O-46 Railroad worker/carman/brakeman/machinist/conductor
O-17   Clerical/office worker                                                 O-47 Refinery worker
O-18   Construction - general                                                 O-48 Remover/installer of gaskets
O-19   Custodian/janitor in office/residential building                       O-49 Rigger/stevedore/seaman
O-20   Custodian/janitor in plant/manufacturing facility                      O-50 Rubber/tire worker
O-21   Electrician/inspector/worker                                           O-51 Sandblaster
O-22   Engineer                                                               O-52 Sheet metal worker/sheet metal mechanic
O-23   Firefighter                                                            O-53 Shipfitter/shipwright/ship builder
O-24   Fireman                                                                O-54 Shipyard worker (md. repair, maintenance)
O-25   Flooring installer/tile installer/tile mechanic                        O-55 Steamfitter
O-26   Foundry worker                                                         O-56 Steelworker
O-27   Furnace worker/repairman/installer                                     O-57 Warehouse worker
O-28   Glass worker                                                           O-58 Welder/blacksmith
O-29   Heavy equipment operator (includes truck, forklift, & crane)           O-59 Other
O-30   Insulator
                                                                       Industry Codes

I-01   Asbestos abatement/removal                                              I-12     Petrochemical
I-02   Aerospace/aviation                                                      I-13     Railroad
I-03   Asbestos mining                                                         I-14     Shipyard-construction/repair
I-04   Automotive                                                              I-15     Textile
I-05   Chemical                                                                I-16     Tire/rubber
I-06   Construction trades                                                     I-17     U.S. Navy
I-07   Iron/steel                                                              I-18     Utilities
I-08   Longshore                                                               I-19     Grace asbestos manufacture or milling
I-09   Maritime                                                                I-20     Non-Grace asbestos manufacture or milling
I-10   Military (other than U.S. Navy)                                         I-21     Other
I-11   Non-asbestos products manufacturing

                                                                       Page 4 of 13
                                                         SPHC Claim Estimation Form



PART 6: ALLEGED EXPOSURE (Continued)

INSTRUCTIONS: Attach additional copies of this page if more space is required.

ALLEGED EXPOSURE SITE 1

Type of Exposure:     Occupational           Non-Occupational          Bystander          Secondary: ___________________________________________
                                                                                                     provide relationship to occupationally exposed person

If the injured party’s asbestos exposure was due in whole or in part to exposure to an occupationally exposed person (i.e. secondary), complete
PART 5 with the exposure information for the occupationally exposed person

Site of Exposure (i.e. Plant or Site Name)


City                                         State          Country                         Employer


Start Date (mm/dd/yyyy)                      End Date (mm/dd/yyyy)                         Occupation Code : O-            Industry Code : I-
                                                                                           (see codes)                      (see codes)
Select the Product Codes for any Bondex/RPM products used at this alleged exposure site:
   P-01      P-02      P-03      P-04        P-05    P-06       P-07     P-08      P-09       P-10     P-11       P-12    P-13      P-14        P-15   P-16

Describe the circumstances of asbestos exposure:


ALLEGED EXPOSURE SITE 2

Type of Exposure:     Occupational           Non-Occupational          Bystander          Secondary: ___________________________________________
                                                                                                     provide relationship to occupationally exposed person

If the injured party’s asbestos exposure was due in whole or in part to exposure to an occupationally exposed person (i.e. secondary), complete PART 5
with the exposure information for the occupationally exposed person

Site of Exposure (i.e. Plant or Site Name)


City                                         State          Country                         Employer


Start Date (mm/dd/yyyy)                      End Date (mm/dd/yyyy)                         Occupation Code : O-            Industry Code : I-
                                                                                           (see codes)                      (see codes)
Select the Product Codes for any Bondex/RPM products used at this alleged exposure site:
   P-01      P-02      P-03      P-04        P-05    P-06       P-07     P-08      P-09       P-10     P-11       P-12    P-13      P-14        P-15   P-16

Describe the circumstances of asbestos exposure:


ALLEGED EXPOSURE SITE 3

Type of Exposure:     Occupational           Non-Occupational          Bystander          Secondary: ___________________________________________
                                                                                                     provide relationship to occupationally exposed person

If the injured party’s asbestos exposure was due in whole or in part to exposure to an occupationally exposed person (i.e. secondary), complete PART 5
with the exposure information for the occupationally exposed person

Site of Exposure (i.e. Plant or Site Name)


City                                         State          Country                         Employer


Start Date (mm/dd/yyyy)                      End Date (mm/dd/yyyy)                         Occupation Code : O-            Industry Code : I-
                                                                                           (see codes)                      (see codes)
Select the Product Codes for any Bondex/RPM products used at this alleged exposure site:
   P-01      P-02      P-03      P-04        P-05    P-06       P-07     P-08      P-09       P-10     P-11       P-12    P-13      P-14        P-15   P-16

Describe the circumstances of asbestos exposure:




                                                                       Page 5 of 13
                                                             SPHC Claim Estimation Form


PART 7: LITIGATION RELATED TO THE INJURED PARTY (Information about Asbestos Lawsuits Filed and Potential Resolutions)

INSTRUCTIONS: Attach additional copies of this page AND associated TABLES A, B, and C for EACH LAWSUIT

LAWSUIT ##________ -of -________ (fill in based on the number of associated lawsuits)

What is the capacity in which tort claim have been made related to the INJURED PARTY (select and fill out for all that apply)?

   Injured Party                                            Personal Representative/Executor                    Dependent Child
   Spouse                                                   Wrongful Death Claimant                             Other


State (list state): _________________________________________                     Disease(s) claimed:
Federal court? (Y/N): ______
                                                                                       Mesothelioma                Kidney cancer
What state county/subdivision or federal district court (fill in the blank):
                                                                                       Lung cancer                 Other alleged asbestos-related malignant
________________________________________________________                               Asbestosis                  condition
Case Number (fill in the blank): _______________________________                       Laryngeal cancer            Other alleged asbestos-related non-
                                                                                                                   malignant condition
Date first filed (mm/dd/yyyy): ________________________________                       Digestive tract
                                                                                   cancer


Was your deposition taken? (Y/N): ______
Were depositions taken of product identification witnesses including the claimant? (Y/N): ______
If co-worker depositions were taken, how many?:              One deposition                          Two or more depositions

Has this claim been resolved either in whole or in part (excluding              If the claim has been resolved in whole or in part, excluding
Bondex/SPHC/Reardon)?: (check one)                                              Bondex/SPHC/Reardon, how was it resolved? (check all that apply):
                                                                                   Trial                                   Settlement
   Whole?                           Part?
                                                                                   Claims against one or more bankruptcy trusts

If resolved at least in part by trial
When was the trial (mm/dd/yyyy): ________________                               Was there a monetary award to plaintiff (Y/N): _______
Was there a plaintiff verdict? (Y/N) _______                                    What was the award of compensatory damages? $________________
Is the case on appeal? (Y/N): _______

Defendant information and claims against other parties

     Defendants named in this lawsuit (fill in the blank): See and fill out attached TABLE A

     Claims against bankruptcy trusts: See and fill out attached TABLE B

     Claims against defendants not previously identified in TABLE A or TABLE B: See and fill out attached TABLE C


Is this lawsuit on any inactive docket? (Y/N): ______
           If yes, on what jurisdiction’s inactive docket is the lawsuit placed? ____________________________________________
           On what date was the lawsuit placed on the inactive docket? (mm/dd/yyyy): ____________________________________




                                                                           Page 6 of 13
                                                   SPHC Claim Estimation Form


                                                                TABLE A
                                                        NAMED DEFENDANTS

LAWSUIT ## ______ -of- ______ (fill in appropriate law suite ## from PART 7)
RELATED CASE NUMBER_______________________(fill in appropriate Case Number from PART 7)
                                                                                          Amount of     Amount of
                                                                                                                    Payment Date
                           Named Defendant                                Claim Status   Settlement /    Payment
                                                                                                                       (M/D/Y)
                                                                                          Judgment      Received
                                                                           Pending
  Bondex International, Inc.                                               DWOP
                                                                           Settled
                                                                           Pending
  RPM, Inc. (SPHC)                                                         DWOP
                                                                           Settled
                                                                           Pending
  RPM International Inc.                                                   DWOP
                                                                           Settled
                                                                           Pending
  Republic Powdered Metals                                                 DWOP
                                                                           Settled
                                                                           Pending
  Georgia Pacific                                                          DWOP
                                                                           Settled
                                                                           Pending
  United States Gypsum                                                     DWOP
                                                                           Settled
                                                                           Pending
  Kaiser Gypsum                                                            DWOP
                                                                           Settled
                                                                           Pending
  Kelly Moore                                                              DWOP
                                                                           Settled
                                                                           Pending
  Durabond                                                                 DWOP
                                                                           Settled
                                                                           Pending
  Synkaloid                                                                DWOP
                                                                           Settled
                                                                           Pending
  Gold Bond                                                                DWOP
                                                                           Settled
                                                                           Pending
  Bestwall                                                                 DWOP
                                                                           Settled
                                                                           Pending
                                                                           DWOP
                                                                           Settled
                                                                           Pending
                                                                           DWOP
                                                                           Settled
                                                                           Pending
                                                                           DWOP
                                                                           Settled
                                                                           Pending
                                                                           DWOP
                                                                           Settled
                                                                           Pending
                                                                           DWOP
                                                                           Settled
                                                                           Pending
                                                                           DWOP
                                                                           Settled
                                                                           Pending
                                                                           DWOP
                                                                           Settled
                                                                           Pending
                                                                           DWOP
                                                                           Settled




                                                               Page 7 of 13
                                                       SPHC Claim Estimation Form


                                                          TABLE A CONTINUED
                                                             NAMED DEFENDANTS

LAWSUIT ## ______ -of- ______ (fill in appropriate law suite ## from PART 7)
RELATED CASE NUMBER_______________________(fill in appropriate Case Number from PART 7)
                                                                                                                       Amount of
                                                                                                    Amount of                           Payment Date
                            Named Defendant                                     Claim Status                            Payment
                                                                                                    Settlement                             (M/D/Y)
                                                                                                                       Received
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
                                                                                 Pending
                                                                                 DWOP
                                                                                 Settled
Note: If more space is required, make the necessary copies of this sheet and continue completing the information of the names of additional defendants
and their corresponding judgment shares.




                                                                    Page 8 of 13
                                                      SPHC Claim Estimation Form


                                                                   TABLE B
BANKRUPTCY TRUSTS A CLAIM HAS BEEN FILED AGAINST OR WHOM A CLAIM MAY BE FILED IN THE FUTURE

LAWSUIT ##        ______ -of- ______ (fill in appropriate law suite ## from PART 7)
CASE NUMBER _______________________(fill in appropriate Case Number from PART 7)
                                                                    Claim may be                     Amount of
                                                     Claim has                                                   Payment Date
                   Trust Name                                        filed in the     Claim Status    Payment
                                                     been filed                                                     (M/D/Y)
                                                                        future                       Received
A&I Corporation Asbestos Bodily Injury Trust           Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
A-Best Asbestos Settlement Trust                       Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
AC&S Asbestos Settlement Trust                         Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Amatex Asbestos Disease Trust Fund                     Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
APG Asbestos Trust                                     Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
API, Inc. Asbestos Settlement Trust                    Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Armstrong World Industries Asbestos Personal           Yes            Yes              Pending
Injury Settlement Trust                                No             No               Dismissed
                                                                                       Paid
ARTRA 524(g) Asbestos Trust                            Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
ASARCO LLC Asbestos Personal Injury                    Yes            Yes              Pending
Settlement Trust                                       No             No               Dismissed
                                                                                       Paid
Babcock & Wilcox Company Asbestos Personal             Yes            Yes              Pending
Injury Settlement Trust                                No             No               Dismissed
                                                                                       Paid
Bartells Asbestos Settlement Trust                     Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Brauer 524(g) Asbestos Trust                           Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Burns and Roe Asbestos Personal Injury                 Yes            Yes              Pending
Settlement Trust                                       No             No               Dismissed
                                                                                       Paid
C. E. Thurston & Sons Asbestos Trust                   Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Celotex Asbestos Settlement Trust                      Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Combustion Engineering 524(g) Asbestos PI Trust        Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Congoleum Plan Trust                                   Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
DII Industries, LLC Asbestos PI Trust                  Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Eagle-Picher Industries Personal Injury Settlement     Yes            Yes              Pending
Trust                                                  No             No               Dismissed
                                                                                       Paid
Federal Mogul U.S. Asbestos Personal Injury Trust      Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Note: Trusts’ table continues in next page.




                                                                  Page 9 of 13
                                                      SPHC Claim Estimation Form


                                                         TABLE B CONTINUED
BANKRUPTCY TRUSTS A CLAIM HAS BEEN FILED AGAINST OR WHOM A CLAIM MAY BE FILED IN THE FUTURE

LAWSUIT ##        ______ -of- ______ (fill in appropriate law suite ## from PART 7)
CASE NUMBER _______________________(fill in appropriate Case Number from PART 7)
                                                                    Claim may be                     Amount of
                                                     Claim has                                                   Payment Date
                   Trust Name                                        filed in the     Claim Status    Payment
                                                     been filed                                                     (M/D/Y)
                                                                        future                       Received
Flintkote Company and Flintkote Mines Limited          Yes            Yes              Pending
Asbestos Personal Injury Trust                         No             No               Dismissed
                                                                                       Paid
Forty-Eight Insulations Qualified Settlement Trust     Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Fuller-Austin Asbestos Settlement Trust                Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
G-I Asbestos Settlement Trust                          Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
H. K. Porter Asbestos Trust                            Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Hercules Chemical Company, Inc. Asbestos Trust         Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
J.T. Thorpe Settlement Trust                           Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
JT Thorpe Company Successor Trust                      Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Kaiser Asbestos Personal Injury Trust                  Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Keene Creditors Trust                                  Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Lummus 524(g) Asbestos PI Trust                        Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Lykes Tort Claims Trust                                Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
M. H. Detrick Company Asbestos Trust                   Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Manville Personal Injury Settlement Trust              Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Muralo Trust                                           Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
NGC Bodily Injury Trust                                Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
North American Refractories Company Asbestos           Yes            Yes              Pending
Personal Injury Settlement Trust                       No             No               Dismissed
                                                                                       Paid
Owens Corning Fibreboard Asbestos Personal             Yes            Yes              Pending
Injury Trust                                           No             No               Dismissed
                                                                                       Paid
Pittsburgh Corning Corporation Asbestos PI Trust       Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
PLI Disbursement Trust                                 Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Note: Trusts’ table continues in next page.




                                                                  Page 10 of 13
                                                      SPHC Claim Estimation Form


                                                         TABLE B CONTINUED
BANKRUPTCY TRUSTS A CLAIM HAS BEEN FILED AGAINST OR WHOM A CLAIM MAY BE FILED IN THE FUTURE

LAWSUIT ##        ______ -of- ______ (fill in appropriate law suite ## from PART 7)
CASE NUMBER _______________________(fill in appropriate Case Number from PART 7)
                                                                    Claim may be                     Amount of
                                                     Claim has                                                   Payment Date
                   Trust Name                                        filed in the     Claim Status    Payment
                                                     been filed                                                     (M/D/Y)
                                                                        future                       Received
Plibrico Asbestos Trust                                Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Porter Hayden Bodily Injury Trust                      Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Quigley Company, Inc. Asbestos PI Trust                Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Raytech Corporation Asbestos Personal Injury           Yes            Yes              Pending
Settlement Trust                                       No             No               Dismissed
                                                                                       Paid
Rock Wool Mfg Company Asbestos Trust                   Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Rutland Fire Clay Company Asbestos Trust               Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Shook & Fletcher Asbestos Settlement Trust             Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Skinner Engine Co. Asbestos Trust                      Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Stone and Webster Asbestos Trust                       Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Swan Asbestos and Silica Settlement Trust              Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
T H Agriculture & Nutrition, LLC Industries            Yes            Yes              Pending
Asbestos Personal Injury Trust                         No             No               Dismissed
                                                                                       Paid
Thorpe Insulation Company Asbestos Personal            Yes            Yes              Pending
Injury Settlement Trust                                No             No               Dismissed
                                                                                       Paid
United States Gypsum Asbestos Personal Injury          Yes            Yes              Pending
Settlement Trust                                       No             No               Dismissed
                                                                                       Paid
United States Lines, Inc. and United States Lines      Yes            Yes              Pending
(S.A.) Inc. Reorganization Trust                       No             No               Dismissed
                                                                                       Paid
United States Mineral Products Company                 Yes            Yes              Pending
Asbestos Personal Injury Settlement Trust              No             No               Dismissed
                                                                                       Paid
UNR Asbestos-Disease Claims Trust                      Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
Utex Industries, Inc. Successor Trust                  Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid
W.R. Grace & Co. Asbestos Personal Injury              Yes            Yes              Pending
Settlement Trust                                       No             No               Dismissed
                                                                                       Paid
Wallace & Gale Company Asbestos Settlement             Yes            Yes              Pending
Trust                                                  No             No               Dismissed
                                                                                       Paid
Western MacArthur-Western Asbestos Trust               Yes            Yes              Pending
                                                       No             No               Dismissed
                                                                                       Paid




                                                                  Page 11 of 13
                                                        SPHC Claim Estimation Form



                                                                     TABLE C
 COMPANIES, PERSONS, OR OTHER PARTIES AGAINST WHOM A LAWSUIT, CIVIL ACTION, OR CLAIM RELATED
   TO THE INJURED PARTY HAS BEEN FILED OR AGAINST WHOM A CLAIM MAY BE FILED IN THE FUTURE

LAWSUIT ##        ______ -of- ______ (fill in appropriate law suite ## from PART 7)
CASE NUMBER _______________________(fill in appropriate Case Number from PART 7)
                                                                                                                        Amount of
                                                                                                     Amount of                           Payment Date
                          Defending Party Name                                  Claim Status                             Payment
                                                                                                     Settlement                             (M/D/Y)
                                                                                                                        Received
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
                                                                                  Pending
                                                                                  DWOP
                                                                                  Settled
Note: If more space is required, make the necessary copies of this sheet and continue completing the information of the names of additional parties and
the corresponding claim status, settlement amount, amount of payment received, and payment date.




                                                                    Page 12 of 13
                                                          SPHC Claim Estimation Form


PART 8: CLAIM CERTIFICATION

INSTRUCTIONS: This claim form must be signed by the claimant’s attorney, or if not represented by an attorney, the claimant or his/her personal
representative.

I have reviewed the information provided on this claim estimation form. I hereby certify, under penalty of perjury, that this information is accurate and
complete to the best of my knowledge.


______________________________________________________                     ______________________
Signature                                                                  Date


______________________________________________________
Print Name




                                                                      Page 13 of 13

				
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