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Risk Management Office

claims@charlottenc.gov

Cameron-Brown Building, Suite 1100 301 South McDowell Street Charlotte, NC 28204-2640

704-336-3301

General Liability Claim Form

Full Name

Full Address

Date and Time of Incident

Date Picker

Weather at time of incident

Was anyone injured?

Property damage?

Describe Your Vehicle


Upload estimate, invoice, and/or photos

Signature

Choose how to sign