Sworn Statement and Proof of Loss (PDF) - City of Lorain 2025

1. Click ‘Get Form’ to open the Sworn Statement and Proof of Loss in our editor.
2. Begin by filling in your current address in section a. This is essential for identifying your location.
3. In section b, enter the date and location of the loss. Accurate details here are crucial for processing your claim.
4. For section c, provide a detailed description of what happened during the loss incident. Be as specific as possible.
5. In section d, indicate whether you have insurance on the property and fill in the amount. Include the name of your insurance company and contact details for the adjuster handling your claim.
6. Complete section e by affirming that all information provided is true to the best of your knowledge.
7. Finally, sign and date the document in front of a notary public as indicated at the bottom of the form.

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