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City of Elizabeth Notice of Claim Form

Steps

  1. 1. Step One
  2. 2. Claim Form
  3. 3. Authorization for Release of Personal & Health Information Pursuant to HIPPA
  • Step One

    1. Tort Claims Against the City of Elizabeth

      Please be advised that in order to place the City of Elizabeth on notice of your intention to file a Tort Claim, the following Notice of Claim Form must be completed and sent to:
      City of Elizabeth Law Department
      50 Winfield Scott Plaza
      Room 201
      Elizabeth, NJ 07201

      The City of Elizabeth Notice of Claim Form is required to be completed in accordance with City Council Resolution dated February 11, 2005 and NJ.S.A. 59:1 - 1 et seq.

      Further be advised that the completed Notice of Claim Form must be postmarked within 90 days of the date of loss in order for it to be considered “ timely ” filed.

      Note: The follow ing items may be helpful in the determination of this claim:
      - Estimate for Damages
      - Insurance (Declaration Page)
      - Picture (s) of Damage (may include location of incident/accident)
      - Police/Accident Report
      - Receipts (out - of - pocket expenses)

      If you require any additional information, you may contact our office at 908-820-4009.