Benefit Application Info

The following information is needed in order to process a line-of-duty/non-line-of-duty death benefit:

A signed letter (on official letterhead) from the head of the department or branch of service that must include the following information:

Please also include a copy of the MARRIAGE CERTIFICATE, DEATH CERTIFICATE  as well as copies of BIRTH CERTIFICATES FOR ANY MINOR CHILDREN of the deceased.

The following information would also be helpful to us in our benefit process:

This information must be submitted to the Hundred Club for approval.  Once processed, the Hundred Club will contact you.

Click here to Download the Benefits Application Form

The information may be mailed to The Hundred Club of Mass., Inc., 17 Gloucester Street, Boston, MA 02115 or sent by facsimile to 617-536-9876, Attention:  Janice Anderson.