webinfo@lincolnri.org
100 Old River Road, Lincoln, RI, 02865, US
401-333-1100
Date of Incident
Incident Location / Reference Points ( IE: Pole #'s, Intersections, Landmarks , Mile Markers ect.. )
Claimant Current Address
Vehicle Operator's Full Address (if different than claimant's address)
Please attach support records and data: [IE: Copy of Accident Report, Pictures of the scene of the damage, pictures of the damaged property, copies of original receipts, bills, or parts purchased, statements or other supporting materials]
A copy of the valid R.I. registration for the vehicle [Attach a scan or image]
Copies of itemized damage, paid receipts with proof of payment for the vehicle
One of these three documents: a copy of police report, a toll receipt, or an auto club report
Please Attest
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