Incident Form

30Sep

28Sep

Justice Court Training

28 Sep, 2026 — 30 Sep, 2026

Event summary

Justice Court Training

Event details

Justice Court Closed for busines Mon- Wed Sept 28-30

Time

28 Sep, 2026 — 30 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

23Sep

Planning Board Meeting 8:00 PM

23 Sep, 2026 PM 8:00 — 23 Sep, 2026 PM 9:00

Event summary

Planning Board Meeting 8:00 PM

Event details

Planning Board Meeting 8:00 PM

Time

23 Sep, 2026 PM 8:00 — 23 Sep, 2026 PM 9:00

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

23Sep

Planning Board Work Session 7:00 PM

23 Sep, 2026 PM 7:00 — 23 Sep, 2026 PM 8:00

Event summary

Planning Board Work Session 7:00 PM

Event details

Planning Board Work Session 7:00 PM

Time

23 Sep, 2026 PM 7:00 — 23 Sep, 2026 PM 8:00

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

22Sep

Tomahawk Water District #3 Flushing

22 Sep, 2026 — 22 Sep, 2026

Event summary

Tomahawk Water District #3 Flushing

Event details

Tomahawk Water District #3 Flushing

Time

22 Sep, 2026 — 22 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

21Sep

Justice Court Criminal

21 Sep, 2026 — 21 Sep, 2026

Event summary

Justice Court Criminal

Event details

Justice Court Criminal

Time

21 Sep, 2026 — 21 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

17Sep

Mtn View Water District #5 Flushing

17 Sep, 2026 — 17 Sep, 2026

Event summary

Mtn View Water District #5 Flushing

Event details

Mtn View Water District #5 Flushing

Time

17 Sep, 2026 — 17 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

16Sep

Oxford Water District #2 Flushing

16 Sep, 2026 — 16 Sep, 2026

Event summary

Oxford Water District #2 Flushing

Event details

Oxford Water District #2 Flushing

Time

16 Sep, 2026 — 16 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

15Sep

Town Board Meeting 7:00 PM

15 Sep, 2026 PM 7:00 — 15 Sep, 2026 PM 9:00

Event summary

Town Board Meeting 7:00 PM

Event details

Town Board Meeting 7:00 PM

Time

15 Sep, 2026 PM 7:00 — 15 Sep, 2026 PM 9:00

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

14Sep

Justice Court

14 Sep, 2026 — 14 Sep, 2026

Event summary

Justice Court

Event details

Justice Court

Time

14 Sep, 2026 — 14 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

14Sep

Tappan Water District #4 Water Flushing

14 Sep, 2026 — 14 Sep, 2026

Event summary

Tappan Water District #4 Water Flushing

Event details

Tappan Water District #4 Water Flushing

Time

14 Sep, 2026 — 14 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

10Sep

Justice Court V & T

10 Sep, 2026 — 10 Sep, 2026

Event summary

Justice Court

Event details

Justice Court

Time

10 Sep, 2026 — 10 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

10Sep

Mobile DMV CANCELLED

10 Sep, 2026 — 10 Sep, 2026

Event summary

Mobile DMV Town Hall 10 AM - 3 PM

Event details

Mobile DMV Town Hall 10 AM - 3 PM

Time

10 Sep, 2026 — 10 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

09Sep

Justice Court V & T

09 Sep, 2026 — 09 Sep, 2026

Event summary

Justice Court

Event details

Justice Court

Time

09 Sep, 2026 — 09 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

08Sep

Town Board Work Session 7:00 PM

08 Sep, 2026 PM 7:00 — 08 Sep, 2026 PM 9:00

Event summary

Town Board Work Session 7:00 PM

Event details

Town Board Work Session 7:00 PM

Time

08 Sep, 2026 PM 7:00 — 08 Sep, 2026 PM 9:00

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

03Sep

Justice Court

03 Sep, 2026 — 03 Sep, 2026

Event summary

Justice Court

Event details

Justice Court

Time

03 Sep, 2026 — 03 Sep, 2026

${DataItem.Address.Title}

${DataItem.Address.MarkerText}

01Sep

Town Board Meeting 7:00 PM

01 Sep, 2026 PM 7:00 — 01 Sep, 2026 PM 9:00

Event summary

Town Board Meeting 7:00 PM

Event details

Town Board Meeting 7:00 PM

Time

01 Sep, 2026 PM 7:00 — 01 Sep, 2026 PM 9:00

${DataItem.Address.Title}

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Town of Blooming Grove Incident Form

The Town Clerk's Office will submit this form to the Town's Insurance Company. Processing this form is not an acknowledgement of fault or liability, those determinations are made by the Town's Insurance Company.

Date
Month - Day - Year
Name of Person Completing Form / Title

First Name
Last Name
Date of Incident
Month - Day - Year
Authority Contacted
Location of Incident
Description of Incident
Description of Injury/Property Damage
Injured/Owner

Address

Street Address
Street Address 2
City	Region
Postal Code	Country

Home Phone
Area CodePhone Number
Business Phone
Area CodePhone Number
Estimate of Damages
Witnesses (Name/Address/Phone)
Miscellaneous Information/Remarks
Captcha

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Town of Blooming Grove Incident Form