Evans, NY · Erie County
Claimant's Notice of Claim
This notice-of-claim form collects details about an alleged injury or property damage for a claimant submitting information to the Town of Evans Town Clerk.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Claimants use this form to give the Town of Evans information about an alleged injury or property damage, including its date, time, place, manner, and the amount claimed. The Town Clerk makes the form available to put the Town on notice, but the form warns that it may not satisfy applicable filing requirements. The form advises consulting an attorney; its resolution also says governing laws and requirements control before a lawsuit is filed.
Who needs it
A person who wants to notify the Town of Evans about an alleged injury or property damage they believe the Town caused or contributed to may use this form.
Why it needs a notary
The form has a subscribed-and-sworn jurat; the claimant signs and swears to the notice before a notary public.
How to get this notarized
- 1
Download the Form
Get the Claimant's Notice of Claim from the Town of Evans.
- 2
Fill In the Claim Details
Provide the requested claimant, incident, and claim information.
- 3
Book an Online Notary
Schedule a session with a commissioned online notary.
- 4
Sign on Video
Sign and swear to the notice during the online notarization session.
- 5
Submit to the Town
Send the notarized form to the Town Clerk at the address listed on the form.
Preview the form
The blank PDF straight from Evans. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I submit a notice of claim to the Town of Evans?
- Complete the form, sign it before a notary, and submit it to the Town Clerk at the address shown. The form cautions that it may not satisfy applicable filing requirements.
- Do I need to sign this notice of claim before a notary?
- Yes. The form includes a subscribed-and-sworn jurat, so the claimant must sign and swear to the notice before a notary public.
- Can I sign the form with a commissioned online notary?
- New York authorizes its notaries to perform remote online notarizations under Executive Law §135-c. Real Property Law §299 recognizes notarial acts performed outside New York by an officer authorized where the act is performed. Confirm with the city, town or village if unsure.
- What information does the form ask for?
- It asks for claimant contact details and information about the alleged claim, including its date, time, place, manner, and amount. Personal injury claimants are also asked about Medicare and for a Social Security number.