Coolidge, AZ · Pinal County
Notice of Claim
This form lets a person submit a claim to the City of Coolidge for injury or damage they believe resulted from a city or employee's actions.
What this form is
Use this form to make a claim against the City of Coolidge and/or an employee for an occurrence that caused injury or damage. It asks for claimant and incident details, descriptions and settlement amounts for property damage and injuries, witness information, and a signed and dated verification. The form says to include supporting documentation and warns that missing information or a specific dollar amount may make the notice defective.
Who needs it
A person claiming injury or property damage caused by the City of Coolidge or a city employee can use this form to provide claim information.
How to submit it
The form says notices must be legally served on the city and on each individual claimed to be responsible. It lists City of Coolidge, 130 W. Central Avenue, Coolidge, AZ 85228, but does not specify a service method.
About notarization
This document is signed and dated without a notary; attach receipts or other documentation for claimed amounts and medical reports where available.
How to submit this form
- 1
Download The Form
Download the Notice of Claim PDF for the City of Coolidge.
- 2
Complete The Claim Details
Fill in the requested claimant, occurrence, damage or injury, settlement amount, witness, and other information.
- 3
Gather Supporting Documents
Attach receipts or other documentation for claimed amounts and medical reports where available.
- 4
Sign And Date The Form
Sign and date the notice, and complete all requested information.
- 5
Legally Serve The Notice
Serve the notice on the city and each individual claimed to be responsible; the form lists the city's street address.
Frequently asked questions
- What information does the Notice of Claim request?
- It requests claimant contact information, occurrence details, descriptions and settlement amounts for damage or injuries, witness information, additional comments, and a signature and date.
- Do I need a notary for the Notice of Claim?
- No. The form asks for a signature and date, not notarization. It says to attach receipts or other documentation of claimed amounts and medical reports where available.
- How do I submit the Notice of Claim?
- The form says the notice must be legally served on the city and on each individual claimed to be responsible. It lists the City of Coolidge at 130 W. Central Avenue, Coolidge, AZ 85228, but gives no service method.