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  Main Office
  1212 Court St NE
  Salem, OR 97301
  Phone: 503-763-3800
  Fax: 503-763-3900

  Claims Office
  PO Box 1469
  Lake Oswego, OR 97035
  Phone: 503-763-3875
  Fax: 503-763-3901

  Legal Office
  280 Liberty St SE
  Suite 206
  Salem, OR 97301
  Phone: 503-779-1070
  Fax: 503-779-2716

CIS is a member service of the League of Oregon Cities and Association of Oregon Counties
 
Automobile Crash Report
 
Use the form below to submit an auto liability or auto physical damage claim to our claims department.

Entity Name  
Contact Name  
Contact Phone  
Date of Accident    
Location of Accident  
Date Reported to Entity  
Person Reported To
Driver of Entity Vehicle  
Vehicle Involved  
Auto Schedule / Item #
VIN #  
Description of Accident
Other Vehicle Involved
License Plate #
Other Passengers Involved in Accident?  
How Many?  
Name of Other Driver
Address
Phone #
Injury
Witnesses
Insert

 
 
   FILING A CLAIM
Emergency Notification Process

Claims Contact Information

WC 801 Claim Form

Automobile Crash Report

General Liability Claim Form

Property Claim Form 
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