What information does the claim notice ask for?

It asks for your name, phone number, address, affected property address if different, incident and damage description, date of loss, date, and signature.

When does the notice say I must provide written notice?

The notice says written notice must be provided within 45 days after the damage or injury was discovered, or when it should have been discovered through reasonable diligence.

Goodrich, MI · Genesee County

No notary required

Genesee County Claim Notice

Claimants use this form to report property damage caused by a sewage backup and provide notice to the Village of Goodrich and county office.

What this form is

This notice is used to submit a claim for property damage resulting from a sewage backup. It asks for claimant contact information, the affected property address, an incident and damage description, the loss date, and a signature; the text says written notice must be provided within 45 days after discovery or when it reasonably should have been discovered.

Who needs it

A person claiming property damage from a sewage backup should complete this notice and provide it to the listed offices.

How to submit it

Return one copy to the Village of Goodrich, 7338 S State, Goodrich, MI 48438, and a copy to the Division of Water and Waste Services, G-4610 Beecher Road, Flint, MI 48532, attention David LaForest.

About notarization

This document is signed without a notary; the claimant signs and dates it, and the document lists no notarized or sworn attachment.

How to submit this form

1
Download the Claim Notice
Download the Genesee County Claim Notice PDF.
2
Complete the Form
Enter your contact information, affected property address, incident and damage description, and date of loss; then sign and date the notice.
3
Check for Attachments
The notice does not list any required attachments.
4
Submit Copies to the Listed Offices
Return one copy to the Village of Goodrich and one to the Division of Water and Waste Services at the addresses on the notice.

Frequently asked questions

Do I need a notary for the Genesee County Claim Notice?: No. This document is signed without a notary; the claimant signs and dates it, and the document lists no notarized or sworn attachment.
How do I submit the Genesee County Claim Notice?: Return one copy to the Village of Goodrich at 7338 S State, Goodrich, MI 48438, and a copy to the Division of Water and Waste Services at G-4610 Beecher Road, Flint, MI 48532, attention David LaForest.
What information does the claim notice ask for?: It asks for your name, phone number, address, affected property address if different, incident and damage description, date of loss, date, and signature.
When does the notice say I must provide written notice?: The notice says written notice must be provided within 45 days after the damage or injury was discovered, or when it should have been discovered through reasonable diligence.

Need something notarized?

This Genesee County Claim Notice doesn’t need a notary — but Michigan residents can notarize other documents online with a commissioned online notary.