Vehicle Damage Claim

Leave This Blank:

Proper notice must be received by the Town within 30 days from the date of the incident.

Vehicle Damage Due to Pothole or Other Roadway Obstruction

Location of the Incident

Vehicle Information

Your Contact Information

This vehicle damage claim form may also be printed and mailed to:

Town of Needham
Vehicle Damage Claims
Department of Finance
Town Hall
1471 Highland Avenue
Needham, MA 02492

(revised 02/07/2012)

* indicates required fields.