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Risk Management Center Claim Form

  1. Liability - Auto - Property Loss Notice Form

  2. Town of Madison, Connecticut

  3. Risk Manager

    Lauren Rhines 8 Campus Drive Madison, CT 06443 rhinesl@madisonct.org (203) 245-5602

  4. Please explain the incident:

  5. Please describe where the incident took place.

  6. (if applicable)

  7. Leave This Blank:

  8. This field is not part of the form submission.