Municipality of Princeton


400 Witherspoon St, Princeton, NJ 08540


Document Signers
    • 1 Signature of Claimant



Pursuant to the provisions of the New Jersey Tort Claims Act, this Notice of Tort Claim form has been adopted as the official form for the filing of claims against Princeton.
The questions are to be answered to the extent of all information available to the Claimant or to his or her attorneys, agents, servants, and employees, under oath. The fully completed Claim Form and the documents requested shall be returned to the will be electronically submitted upon completion of this form.

NOTE CAREFULLY: Your claim will not be considered filed as required by the New Jersey Tort Claims Act until this completed form has been filed with Princeton. Failure to provide the information requested, including such responses as "To Be Provided" or "Under Investigation" will result in the claim being treated as not being properly filed.

Timely Notices of Claim must be filed within 90 days after the incident giving rise to the claim.

This form is designed as a general form for use with respect to all claims. Some of the questions may not be applicable to your particular claim. For example, if your claim does not arise out of an automobile accident, questions regarding road conditions might not be applicable. In that event, please indicate "Not Applicable".
If you are unable to answer any question because of a lack of information available to you, specify the reason the information is not available to you. If a question asks that you identify a document, it will be sufficient to furnish true and legible copies. Where a question asks that you "identify all persons," provide the name, address and telephone number of the person.
If you need more space to provide a full answer, attach supplementary pages, identifying the continuation of the answer with the number of the applicable question.
Shall refer to the person or persons on whose behalf the Notice of Claim has been filed with the Princeton.
Shall refer to any written, photographic or electronic representation, and any copy thereof, including, but not limited to, computer tapes and/or disks, videotapes and other material relating to the subject matter of the claim.
Shall include- in its meaning a partnership, joint venture, corporation, association, trust or any other kind of entity, as well as a natural person.
Public Entity:
Shall refer to Princeton along with any agent, official or employee of Princeton against whom a claim is asserted by the Claimant.

NOTE that the questions are divided into sections relating to the claimant, the claim, property damage, personal injury and the basis for the claim against the public entity or a public employee.

If the claim involves only property damage, then the portion on personal injuries need not be answered. Just enter as the answer to Question 17 "No personal injuries claimed."

If the claim involves no property damage, then the portion on property damage need not be answered. Just enter as the answer to Question 16 "No damage claimed."

If you have any questions about this form and the information needed please contact the Human Resources Department at 609-454-4751.

This application works best using the Google Chrome web browser. If possible please do so to avoid any problems or delays.
Please check that you agree before continuing.
By continuing I acknowledge I have read and understand the instructions and requirements to complete this form.
I.N.Click to Sign
Signature HereClick to Sign
06/19/2018Click to Sign
Signature HereClick to Sign
Signature HereClick to Sign

Create Your Signature

Please fill in your name and email and then either draw or type your signature below.


Signature Type

Type Draw Upload Custom
Clear Signature

Signature will be applied to the page. You will have a chance to review after signing.

Check this box to continue


Additional Signatures Required