MV-104 Claim Form

Filling Out an MV-104 Form

Drivers involved in car accidents in the state of New York in which there has been a fatality, personal injuries, or property damages totaling more than $1,000 are required to complete an MV-104 form within 10 days. 

We urge you not to submit this form until it has been reviewed by an attorney who is aware of all the facts and circumstances of your matter. 

The car accident lawyers at the William Mattar Law Offices can help. 

Download the MV-104 form. 


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