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Get Blumberg Small Claims Form

RPORATION 110 WILLIAM ST. NEW YORK, N.Y. 10038 phone: 646-205-7800 State of New York County of Pursuant to Article 52 and or pertinent sections of Article 18 of the Insurance Law of the State of New York, this affidavit is presented to the Motor Vehicle Accident Indemnification Corporation for the purpose of giving my Notice of Intention to Make Claim against said Motor Vehicle Accident Corp. for injuries sustained by me. I have been duly sworn and state: ; my date of birth is My name is I re.

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