Notice of Injury and Claim Form - Wisconsin Department of Justice - doj state wi 2025

1. Click ‘Get Form’ to open the Notice of Injury and Claim Form in the editor.
2. Begin by entering the Claimant’s Name, Address, and Phone number in the designated fields. Ensure that all information is accurate for effective communication.
3. Fill in the Time and Date of Occurrence. This is crucial as it establishes the timeline for your claim.
4. Specify the Location where the incident occurred. Be as detailed as possible to avoid any confusion.
5. In the Statement of Circumstances section, provide a thorough description of what happened, including names of any involved parties, especially state officers or employees. If you need more space, utilize the backside of the form.
6. Review your entries carefully. Once satisfied, sign and date the form at the bottom to certify its accuracy.
7. Finally, ensure that you have a notary public witness your signature before submitting it via certified mail to the Attorney General's office within 120 days.

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