Tort Transmittal Form Tort Transmittal Form JIF: ACCASBO BCIP GCSSD Member District:*Address:*Email of District Employee Completing this Form:* Date Reported (Do we need this?)Name of Claimant:*Date of Loss/Accident:*JIF Claim Number:Enclosed please find the following: Initial Notice of Tort claim received on ___________________ and wording….Include photocopy of envelope showing postal date stamp Copy of response, sent on ____________________ by certified mail, return receipt requested, with the official Notice of Tort Claim form. Reports on the incident giving rise to the claim. Official Notice of Tort Claim Form, received on ________________________. Summons and Complaint, received on _____________________________. 2 Signature Lines Here Incident Description including Initial Notice of Tort claim, Copy of Response, Reports on the incident giving Rise to the Claim, Summons and Complaint:EmailThis field is for validation purposes and should be left unchanged.