Your Details
Contact Information
We will use this to keep you informed throughout your claim

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Please enter in Capitals

Employment Details

Particulars of Incident
Please enter in format DD/MM/YYYY
Please enter in hours and minutes HH:MM eg: 14:04

Please provide details of each witness

Details of loss or damage
For vehicle damage claims please submit a complete copy of the Vehicle Registration Document V5.
Please enter in format DD/MM/YYYY
Please provide 2 written quotations using file upload below

Additional Evidence
Please upload any additional evidence you need to provide here


Disclosure of Information 

We may check information provided by you, or information about you provided by a third party, with other information held by us. We may also get information from third parties, or give information to check the accuracy of the information, to prevent or detect crime, or to protect public funds in other ways, as permitted by law.

We will not disclose information about you to anyone outside Stockton Borough Council or use information about you for other purposes unless the law permits us to. 

Stockton on Tees Borough Council is a registered data controller. If you want to know more about what information we have about you or the way we use your information, please contact the Information Governance Team. For more information on how we use your personal data please view our Privacy Notice