Follow the steps to complete your claim form.

1. Press the ‘Get Form’ button to access the claim form and open it in your preferred document editor.
2. In the section titled 'Claimant Information,' provide the claimant's last name, first name, address, tax ID, phone number, email address, date of birth, social security number, and any other requested details marked with an asterisk (*).
3. For the 'Time and Place Where the Claim Arose' section, fill in the date and time of the incident, location, and describe how the claim arose. Use an additional sheet if necessary.
4. Under 'Medical Information,' enter the date of the first treatment, the name and address of the hospital, and answer whether the claimant was taken to the hospital by ambulance.
5. If applicable, in the 'Employment Information' section, provide your employer's name and address, number of work days lost, and weekly earnings.
6. Complete the witness information sections by listing the names and addresses of up to six witnesses related to the incident.
7. If your claim involves a NYC vehicle, fill out the vehicle owner's details and insurance information. Also, provide details about the nature of the claimant (driver, passenger, etc.) and the total amount claimed.
8. Finally, sign the form in the claim statement area, ensuring that it is notarized as required. Review for completeness before proceeding.
9. After filling out all sections, save your changes, download the form, print it as needed, and share it for submission to the NYC Comptroller’s Office.

Complete your Comptroller NYC Claim online and take the important step toward seeking compensation.