Form Center

2. 

3. Please complete the form and submit online directly. You may also return this form to Human Resources at the Business Development Center located at 110 S. Bolivar St. (2nd floor) or return by mail to the following address:

   
   

   City of Marshall

   P.O. Box 698 

   Marshall, TX 75671

   
   

   Questions?  Please call (903) 935-4425 or email

   Claims.Risk@marshalltexas.net

5. Please make sure to include all photos and information when submitting this claim
7. Name
9. Address
11. City
12. State
13. Zip Code
15. Phone Number
16. Email Address
18. Date of Accident or Loss
    Date of Accident or Loss
20. Location of Accident or Loss
22. Description of Accident or Loss
24. Complete this section if the claim is related to damage to an automobile or an automobile accident
26. Year
27. Make
28. Model
30. Vehicle Identification Number (VIN)
32. Description of Damage
34. Please include photos or other documentation
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit Submit and Print

* indicates a required field