Permit Details | City of North Bay

To make an claim alleging City negligence relating to property loss or personal injury.

Documents & Links

Document Claim Form

Online Form

Complainant Information

Full Name * Type in your first and last name

Mailing Address * Type in your full mailing address, including postal code

Telephone Number * Type in the best number to reach you by telephone

Email Address * Type in your email address

Claim Information

Date of Loss/Claim * Select the date of loss/claim; if unsure, type in the Description of Loss/Claim field

Time of Loss/Claim *

Location of Loss/Claim * Type in the address or coordinates of the location

Details of Loss/Claim * Type in details and supporting information related to the loss/claim

Attachments Attach photos or proof for your loss/claim

Consent

Acknowledgement & Consent * By checking this box, I affirm that my statement(s) made above is true.

I affirm that my statement(s) made above is/are true.

Consent for collection, use and storing data * I acknowledge that my information will be collected, used and stored by the City

Yes, I give permission to collect, store and process my data.

Personal information on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act and will be used for its intended purpose only. Questions about this collection or personal information should be directed to the City Clerk, 200 McIntyre Street East, North Bay ON P1B 8V6, or by telephone at (705) 474-0626 ext. 2510.

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