Please fill out the following information in order to receive a Notice of Claim Form. After filling out the form below, you will be able to download the Notice of Claim Form in Adobe Acrobat (.pdf) or Microsoft Word (.doc) format.
The request form below does not constitute notice to the State Treasurer. You still must fill out the Notice of Claim Form on the following page and submit it to the State Treasurer's Office and Environmental Health & Safety in order to process your claim. If you have any questions, please contact EHS at x42949 or firstname.lastname@example.org.
We would greatly appreciate your feedback about this site. If you have any questions or need additional information, please contact us at
email@example.com or 410-704-2949.
Copyright © 2002 Towson University Department of Environmental Health & Safety.
Last updated 03/17/2006