Claim Form

Under the Cities and Towns Act, any person who intends to claim damages from the Town for a material loss shall, within 15 days from the date of the accident, give or cause to be given notice in writing to the clerk of the municipality of such intention, containing the particulars of his claim, and stating the place of his residence. If you fail to transmit such notice, your claim will unfortunately be considered legally inadmissible.

Notwithstanding the foregoing, no written notice is required in order to claim for a bodily injury, although such notice is strongly recommended.

Personal information

Mr.

Ms.

First name

Last name

Address

Phone number

Email

Incident details

Date of the incident

Time of the incident

Location of the incident

Type of incident

Please specify the nature of the incident, if you have selected the "Other" option:

Details of the incident

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SPVM

Public Security

Yes

No

Photo of the incident (if applicable)

Drop files here or click to upload them.

Estimated value of damage (CAD$)

Estimate or supporting document of value (if applicable)

Drop files here or click to upload them.

I agree that the Town of Mount Royal may collect, use, and disclose my personal information solely for the purpose of processing this request, in accordance with the Town's privacy policy and applicable privacy laws.

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Personal information

Incident details

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