Bloomfield, MT · Essex County
Tort Claim Form
Bloomfield’s Tort Claim Form lets a claimant provide incident, injury, property damage, and loss information when filing a claim against the township.
What this form is
This form is used to file a notice of claim against Bloomfield and requests claimant and attorney details, incident information, and supporting details about property damage, injuries, and losses. The form says timely notices must be filed within 90 days after the incident and directs claimants to return the completed form and requested documents to the Township Law Department.
Who needs it
A person filing a claim against Bloomfield should complete this form with available information and provide the requested documents.
How to submit it
Return the completed original claim form and requested documents to the Township of Bloomfield Law Department, Law Enforcement Building, Municipal Plaza, Bloomfield, New Jersey 07003-3487.
About notarization
This document is signed without a notary; its instructions say answers are under oath, but the claimant signs and dates the certification and medical release.
How to submit this form
- 1
Download The Form
Download the Bloomfield Tort Claim Form PDF.
- 2
Complete The Form
Answer the applicable questions with available information; the form says to mark irrelevant questions “Not Applicable.”
- 3
Gather Requested Documents
Attach documents identified in your answers and the requested supporting records; auto claims require a car insurance declaration page.
- 4
Submit The Original
Return the completed original form and requested documents to the Township of Bloomfield Law Department at the address printed on the form.
Frequently asked questions
- What is the Bloomfield Tort Claim Form for?
- It is the township’s form for filing a notice of claim. It asks for information about the claimant, incident, alleged injury or property damage, and claimed losses.
- Do I need a notary for the Bloomfield Tort Claim Form?
- No. The form has claimant signature and date lines but no notary block. Its instructions say answers are under oath, and the claimant signs and dates the certification and medical release.
- How do I submit the Bloomfield Tort Claim Form?
- Return the completed original form and requested documents to the Township of Bloomfield Law Department, Law Enforcement Building, Municipal Plaza, Bloomfield, New Jersey 07003-3487.
- What documents should I include with the claim?
- The form requests documents identified in your answers, including copies of bills, repair estimates for property damage, and specified medical, expert, or wage-loss records. Auto claims require a copy of the car insurance declaration page.
Need something notarized?
This Tort Claim Form doesn’t need a notary — but if you have another Bloomfield form that does, a commissioned online notary can help.