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* 1. Your Police Services Board

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* 2. Your Name

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* 3. How many claims made against the municipality or OPP which named the OPP Service Board as a defendant, regardless of the activity. For these claims, we are looking for the total number received in the last 10 years only.

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* 4. How many claims have been made against your municipality or the OPP which named the Section 10 Police Service Board as a defendant?

Please follow out the following questions based on one claim from question 4. If you have not had a claim please do not fill out the questions below. All questions below should be filled out based on one claim and then submitted. If you have had more than one claim please fill out the survey for each remaining claim. For example, if you have had three claims please fill out the survey three times.

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* 5. Type of Claim

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* 6. Date of Loss

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* 7. Deductible Applied

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* 8. The Status of the Claim

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* 9. For open claims, please note the expenses paid by date.

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* 10. For closed claims, please note the total expenses.

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