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Download a Claim Form

If you’d prefer to download a PDF form, you’ll need to email, mail, or fax your claim to us. To fill out the form electronically, please download Adobe Reader.

Claim Form

English

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How to Send Us Your Claim

Email us, fax 1-914-925-9250, or mail it to Orange and Rockland Utilities, Inc, Claims Department, PO Box 1008, Spring Valley, NY 10977.