Endicott, NY · Broome County
Notice of Claim Against the Village of Endicott
This form lets a claimant report an injury or damage claim against the Village of Endicott and describe the incident, alleged negligence, and damages.
What this form is
Claimants use this form to make a claim against the Village of Endicott for injuries allegedly caused by the Village or its personnel. It asks for the claimant’s contact information, the incident’s time and place, details of injuries or damage, the basis for the claim, and the amount claimed. The instructions say to identify an injured infant’s parent or guardian and to attach expenses from the incident.
Who needs it
A person seeking damages for injuries or other harm allegedly caused by the Village of Endicott can use this form to state the claim.
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 claim form is signed and dated without a notary; it asks claimants to attach expenses from the alleged incident, but does not require them to be sworn.
How to submit this form
- 1
Download The Form
Download the Notice of Claim PDF for the Village of Endicott.
- 2
Complete The Claim Details
Provide claimant and correspondence information, describe the incident and alleged harm, and state the amount claimed.
- 3
Gather Expense Attachments
Attach expenses incurred in the alleged incident, as requested on the form.
- 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 form provides a signature and date line but does not require notarization. It asks claimants to attach expenses from the alleged incident, but does not say those attachments must be sworn.
- What information does the Notice of Claim ask for?
- It asks for claimant and correspondence details, the incident’s time and place, injury or damage information, the alleged basis for the Village’s responsibility, any known employee names, and the amount claimed.
- How do I submit the Notice of Claim?
- The document does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.