Newburgh, NY · Orange County
Notice of Claim
This Notice of Claim form lets a claimant describe an incident, alleged injuries or damages, and a demand for adjustment and payment to the Town of Newburgh.
- 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
The form records the claimant’s name and address, the nature of the claim, when and where the incident happened, and the damages or injuries claimed. It includes a statement that the claim is presented for adjustment and payment, and provides space for the claimant’s signature and sworn statement. The form is addressed to the Town of Newburgh and lists Town Hall as the presentation address; use it when presenting a claim against the town.
Who needs it
A claimant seeking adjustment and payment from the Town of Newburgh can use this form to provide details about the claim and the incident.
Why it needs a notary
The form carries a jurat stating “Sworn to before me”; the claimant signs the statement and swears to its truth before the notary.
How to get this notarized
- 1
Download The Form
Get the Town of Newburgh Notice of Claim form.
- 2
Fill In Claim Details
Enter the claimant’s information, claim description, incident details, and claimed damages or injuries.
- 3
Book An Online Notary
Schedule a remote session with a commissioned online notary and have your identification ready.
- 4
Sign On Video
Sign the claimant’s sworn statement during the video session as directed by the notary.
- 5
Submit To The Town
Present the completed form to the Town of Newburgh at the address listed on the form.
Preview the form
The blank PDF straight from Newburgh. 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 complete and submit this Notice of Claim?
- Fill in the claimant, incident, and damage details, then sign the sworn statement before a notary. The form lists Town of Newburgh Town Hall as the presentation address.
- Do I need to sign the form in front of a notary?
- Yes. The form includes a jurat stating that the claimant’s statement was sworn to before a notary, so sign that statement in the notary’s presence.
- Can I use an online notary for this form?
- New York authorizes its notaries to perform remote online notarizations under Executive Law §135-c. A commissioned online notary can notarize your jurat by video; confirm with the city, town or village if unsure.
- What should I bring to my online notarization?
- Have the completed form and identification ready. Leave the signature for the sworn statement unsigned until the commissioned online notary directs you to sign during the video session.
Other forms in Newburgh
Notice of Claim in other New York cities
Each city publishes its own version of this form. Pick the city where you’re filing.