What does the Sewer Overflow and Backup Claim Form report?

It gives the City of Lincoln Park written notice of a claim involving property damage or personal injury related to a sewage disposal system event.

What information does the claim form ask for?

It asks for claimant names and contact details, the affected property address, the discovery date, a brief claim description, and details of damaged items or physical injuries.

Do I need a notary for the Sewer Overflow and Backup Claim Form?

No. The form has a claimant signature and date line but no notary block or notarized attachment; the claimant just signs and dates it.

How do I submit the Sewer Overflow and Backup Claim Form?

Return the completed form to the City of Lincoln Park Finance Department at 1355 Southfield Rd., Lincoln Park, MI 48146. The document says written notice must be made within 45 days after discovery.

Lincoln Park, MI · Wayne County

No notary required

Sewer Overflow and Backup Claim Form

Property owners or occupants use this form to report a claim for property damage or personal injury related to a sewage disposal system event.

What this form is

Use this form to give the City of Lincoln Park written notice of a claim for property damage or personal injury related to a sewage disposal system event. The form asks for claimant contact details, the affected property address, the date the damage or injury was discovered, and descriptions of the claim and any damaged items or injuries. The document says written notice must be made within 45 days after discovery.

Who needs it

A claimant reporting property damage or personal injury from a sewage disposal system event should complete and submit this form to the city.

How to submit it

Return the completed form to the City of Lincoln Park Finance Department, 1355 Southfield Rd., Lincoln Park, MI 48146.

About notarization

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

How to submit this form

1
Download the Form
Download the Sewer Overflow and Backup Claim Form.
2
Complete the Claim Details
Enter claimant contact details, the affected property address, discovery date, and descriptions of the claim and any damage or injuries.
3
Review and Sign
Review the information, then sign and date the form.
4
Return the Form
Return it to the City of Lincoln Park Finance Department at 1355 Southfield Rd., Lincoln Park, MI 48146.

Frequently asked questions

What does the Sewer Overflow and Backup Claim Form report?: It gives the City of Lincoln Park written notice of a claim involving property damage or personal injury related to a sewage disposal system event.
What information does the claim form ask for?: It asks for claimant names and contact details, the affected property address, the discovery date, a brief claim description, and details of damaged items or physical injuries.
Do I need a notary for the Sewer Overflow and Backup Claim Form?: No. The form has a claimant signature and date line but no notary block or notarized attachment; the claimant just signs and dates it.
How do I submit the Sewer Overflow and Backup Claim Form?: Return the completed form to the City of Lincoln Park Finance Department at 1355 Southfield Rd., Lincoln Park, MI 48146. The document says written notice must be made within 45 days after discovery.

Need something notarized?

This Sewer Overflow and Backup Claim Form doesn’t need a notary — but Michigan residents can notarize other documents online with a commissioned online notary.