Edgewater, MT · Bergen County
Notice of Claim
This form lets a claimant report an accident or other occurrence and describe claimed losses to the municipality or agency they believe caused them.
What this form is
The Notice of Claim collects details about an accident or occurrence, the claimant, the alleged responsible municipality or agency, witnesses, and the damages claimed. It asks for information about injuries, medical care, lost wages, property damage, insurance, and other claims. The form also includes authorizations for medical records and employment information, with signature and date lines for the claimant.
Who needs it
A person making a claim for damages against a municipality or agency can use this form to provide the requested claim and loss information.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This notice is signed and dated without a notary; the medical-records and employment-information authorizations also require signatures and dates, not notarization.
How to submit this form
- 1
Download The Form
Download the Notice of Claim PDF for Edgewater.
- 2
Complete The Claim Details
Fill in the claimant, occurrence, municipality or agency, witness, and damages information requested.
- 3
Complete The Authorizations
Review and sign and date the medical-records and employment-information authorizations if applicable.
- 4
Submit The Form
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Notice of Claim?
- No. The notice is signed and dated without a notary. The medical-records and employment-information authorizations also have signature and date lines, but do not call for notarization.
- How do I submit the Notice of Claim?
- The form does not provide submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
- What information does the Notice of Claim ask for?
- It asks for claimant and occurrence details, the alleged responsible municipality or agency, witnesses, claimed damages, and related medical, employment, insurance, and other claim information.