Claim Form

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Disclaimer

Far below normal precipitation has caused a drought and increased fire danger levels. All of Connecticut is currently in a Stage 2 Drought Advisory. Residents are encouraged to be mindful of water consumption and use extra caution to prevent fires. An emergency burn ban remains in effect at all state parks, forests, and wildlife management areas, prohibiting the use of all outdoor grills, firepits, campfires, etc.

Claim Forms

The forms below should be used only by municipalities to request reimbursement from the Fund under P.A. 23-204, Section 159. Individuals may not make claims directly to the Fund. The program is designed for the Fund to reimburse the municipality for claims paid for all types of eligible expenses under the new program. All claims under P.A. 23-204, Section 159 must be made to the municipality, with no mechanism or authority provided for the Fund to process individual claims directly. Additional information is available in the “Overview and Directions for Municipal Reimbursement Claims” below.

Municipal Reimbursement Request Form (A1)

Firefighter Eligibility Form (A)

Overview and Directions for Municipal Reimbursement Claims

The Office of Treasurer Erick Russell

Claim Forms