Florence, AZ · Pinal County
Notice of Claim
The Notice of Claim form lets a claimant provide the Town of Florence with information about an incident and claimed property damage or injuries.
What this form is
Use this form to make a claim against the Town of Florence and/or an employee. It asks for claimant contact information, incident details, claimed property damage and injuries, settlement amounts, witnesses, and a signature and date. The form says to provide specific dollar amounts supported by evidence and warns that missing requested information may make the notice defective.
Who needs it
A person making a claim against the Town of Florence and/or an employee for property damage or personal injuries can use this form.
How to submit it
The form says notices must be legally served on the Town and each individual claimed responsible. It lists Town of Florence, 775 N. Main Street, P.O. Box 2670, Florence, Arizona 85132.
About notarization
This document is signed and dated without a notary; attach receipts or other documentation of claimed amounts and medical reports where available.
How to submit this form
- 1
Download The Form
Download the Town of Florence Notice of Claim PDF.
- 2
Complete The Claim
Fill in the requested claimant, incident, damage or injury, settlement amount, witness, and other information.
- 3
Gather Supporting Documents
Attach receipts or other documentation of claimed amounts and medical reports where available.
- 4
Sign And Date
Sign and date the notice; the form warns that all requested information should be provided.
- 5
Serve The Notice
Legally serve the notice on the Town and each individual claimed responsible, as stated on the form.
Frequently asked questions
- What information does the Notice of Claim ask for?
- It requests claimant contact details, occurrence information, descriptions and dollar amounts for damage or injuries, witnesses, additional comments, and a signature and date.
- Do I need a notary for the Notice of Claim?
- No. The form calls for a signature and date, not notarization. Attach receipts or other documentation of claimed amounts and medical reports where available.
- How do I submit the Notice of Claim?
- The form says to legally serve the notice on the Town and each individual claimed responsible. It lists the Town's street and mailing addresses.
- What supporting documents does the form mention?
- The form requests receipts or other documentation supporting the amounts claimed, and medical reports where available.
Need something notarized?
This Notice of Claim doesn’t need a notary — but if you have another Florence form that does, a commissioned online notary can help.