Alameda County, CA · Alameda County
Claim Against the County of Alameda
This claim form lets a person submit a claim to Alameda County describing a loss, its circumstances, and the amount requested.
At a glance
- Issued by
- City of Alameda County · Alameda County, Alameda County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- acgov.org
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this form to present a claim against Alameda County for an accident, injury, damage, or other loss. It asks for the claimant’s contact details, the date and location of the loss, a description of what happened, and an itemized amount. The form requests copies of supporting attachments, such as estimates, bills, receipts, or a police report.
Who needs it
A person submitting a claim against Alameda County for an accident, injury, damage, or other loss can use this form.
How to submit it
Return the signed original to the Clerk, Board of Supervisors Office, Administration Building, 1221 Oak Street, Room 536, Oakland, CA 94612. Include copies of attachments supporting the claim.
About notarization
This document is signed without a notary; the signer signs and dates the form, and supporting attachments are requested without any notarization instruction.
How to submit this form
- 1
Download the Form
Download the Claim Against the County of Alameda form.
- 2
Complete the Form
Type or print the claimant’s details, information about the loss, and the itemized amount claimed.
- 3
Gather Supporting Copies
Include copies of attachments supporting the claim, such as estimates, bills, receipts, or a police report.
- 4
Sign and Date
Sign the form and enter the date.
- 5
Return the Original
Send the signed original and copies of supporting attachments to the Clerk, Board of Supervisors Office at the address on the form.
Frequently asked questions
- Do I need a notary for the Claim Against the County of Alameda?
- No. The form has no notary block; the claimant signs and dates it. Copies of supporting attachments are requested, but the form gives no notarization instruction for them.
- How do I submit the claim?
- Return the signed original to the Clerk, Board of Supervisors Office, Administration Building, 1221 Oak Street, Room 536, Oakland, CA 94612. Include copies of supporting attachments.
- What information does the claim form request?
- It asks for claimant and notice contact details, the amount claimed, the date and location of the loss, descriptions of what happened and the resulting loss, and an itemization.
- What attachments should I include?
- The form requests copies of attachments supporting the claim and gives estimates, bills, receipts, and a police report as examples.