Village of Pelham, NY · Westchester County
Notice of Claim
This Notice of Claim records an injury or damage claim against the Village of Pelham and is submitted by the claimant to the Village 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
The form records the claimant’s contact information, when and where an injury or damage occurred, and a description of the occurrence and resulting harm. The form says the Notice of Claim must be served on the Village Clerk in person or by certified mail within 90 days after the claim arises. The claimant also swears that the information is true to their knowledge, except for matters stated on information and belief.
Who needs it
A person making an injury or property-damage claim against the Village of Pelham can use this form to provide the claim details to the Village Clerk.
Why it needs a notary
The form includes a sworn statement and jurat; the claimant named in the notice signs and swears to its contents before the notary.
How to get this notarized
- 1
Download the Form
Get the Notice of Claim from the Village of Pelham.
- 2
Fill In the Claim Details
Provide claimant contact information and describe when, where, and how the injury or damage occurred.
- 3
Book an Online Notary
Arrange a remote notarization with a commissioned online notary.
- 4
Sign on Video
Appear for the online notary session and swear to the statement before signing.
- 5
Serve the Village Clerk
Serve the completed notice in person or by certified mail within 90 days after the claim arises.
Preview the form
The blank PDF straight from Village of Pelham. 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 this Notice of Claim?
- The form says to serve it on the Village Clerk in person or by certified mail within 90 days after the claim arises.
- Do I need to sign this form before a notary?
- Yes. The form includes a sworn statement and jurat, so the claimant signs and swears to the contents before a notary.
- Can I use an online notary for this form?
- New York authorizes remote online notarization by a commissioned online notary under Executive Law §135-c. Confirm the Village’s submission requirements if you are unsure.
- What details should I include?
- The form asks for claimant contact details, the date and time and location of the injury or damage, and descriptions of the occurrence and injury or damage. Confirm with the city, town or village if unsure.
Notice of Claim in other Westchester County cities
Each city publishes its own version of this form. Pick the city where you’re filing.