Englewood Cliffs, MT · Bergen County
Tort Claim Notice
Claimants use this notice to report an accident or occurrence and claim damages from the municipality or agency they identify.
What this form is
The notice records claimant and accident details, describes alleged municipal acts, and documents claimed bodily injury, property damage, lost income, and other losses. It asks for supporting materials such as medical bills, property appraisals or estimates, expert or physician reports, and employer wage verification. Claimants also sign certifications and medical-records and employment-information authorizations.
Who needs it
A person claiming damages from a municipality or agency for an accident or occurrence can complete this notice and provide the requested supporting documents.
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 claimant also signs and dates the medical-records and employment-information authorizations.
How to submit this form
- 1
Download The Notice
Download the Tort Claim Notice PDF.
- 2
Complete The Notice
Fill in claimant, accident, damage, and loss details, then sign and date the certification and applicable authorizations.
- 3
Gather Supporting Documents
Attach the bills, appraisals or estimates, reports, wage verification, and other materials listed on the form that apply to your claim.
- 4
Submit To The City
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 Tort Claim Notice?
- No. The notice is signed and dated without a notary; the claimant also signs and dates the medical-records and employment-information authorizations.
- What information does the Tort Claim Notice request?
- It requests claimant and accident details, information about the alleged municipal acts, and details about claimed injuries, property damage, lost income, and other losses.
- What documents should I attach to the Tort Claim Notice?
- The form lists itemized bills, appraisals and property-damage estimates, expert or treating-physician reports, and employer wage verification. Self-employed claimants should attach a lost-income calculation.
- How do I submit the Tort Claim Notice?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Tort Claim Notice doesn’t need a notary — but if you have another Englewood Cliffs form that does, a commissioned online notary can help.