Do I need a notary for the City of Hayward claim form?

No. The form has no notary block. The claimant signs and dates a declaration under penalty of perjury that the information is true and correct.

How do I submit a claim to the City of Hayward?

Submit the completed claim and related documentation to the City Clerk of Hayward at 777 “B” Street, Hayward, California, 94541-5007. Personal service is described during regular City business hours, Monday through Friday, excluding City holidays.

What information does the claim form ask for?

It asks for claimant contact details, when and where the incident occurred, what happened, the damage or injury, the amount claimed, and how the amount was calculated.

Can I attach documents to support my claim?

Yes. The instructions say to attach copies of supporting documentation, such as bills, payment receipts, or cost estimates, if you have them.

Hayward, CA · Alameda County

No notary required

Claim Presented to the City of Hayward

This claim form is for people seeking compensation from the City of Hayward for alleged damage or injury they believe the City caused.

What this form is

Use this form to present a claim to the City of Hayward for alleged damage or injury. It asks for claimant and incident details, the location and circumstances, the damage or injury, the amount claimed, and how that amount was calculated; attach copies of supporting bills, receipts, or estimates if available. The instructions describe presentation time limits based on the type of claim and explain that late claims require an application for leave.

Who needs it

People claiming that the City of Hayward caused damage or injury should complete and submit this form, with supporting documentation if available.

How to submit it

Submit the completed claim and related documentation to the City Clerk of Hayward, 777 “B” Street, Hayward, California, 94541-5007. The instructions say personal service is available during regular City business hours, Monday through Friday, excluding City holidays.

About notarization

This document is signed without a notary; the claimant declares under penalty of perjury that the information is true and correct, then signs and dates the claim.

How to submit this form

1
Download the Claim Form
Download the City of Hayward claim form and read the instructions before completing it.
2
Complete Each Section
Type or print clearly, provide the requested claimant and incident information, explain the claim, and sign and date the form.
3
Gather Supporting Documents
Attach copies of available bills, payment receipts, cost estimates, and other related documentation.
4
Submit to the City Clerk
Send or personally serve the completed claim and related documentation to the City Clerk of Hayward at the address listed in the instructions.

Frequently asked questions

Do I need a notary for the City of Hayward claim form?: No. The form has no notary block. The claimant signs and dates a declaration under penalty of perjury that the information is true and correct.
How do I submit a claim to the City of Hayward?: Submit the completed claim and related documentation to the City Clerk of Hayward at 777 “B” Street, Hayward, California, 94541-5007. Personal service is described during regular City business hours, Monday through Friday, excluding City holidays.
What information does the claim form ask for?: It asks for claimant contact details, when and where the incident occurred, what happened, the damage or injury, the amount claimed, and how the amount was calculated.
Can I attach documents to support my claim?: Yes. The instructions say to attach copies of supporting documentation, such as bills, payment receipts, or cost estimates, if you have them.

Need something notarized?

This Claim Presented to the City of Hayward doesn’t need a notary — but if you have another Hayward form that does, a commissioned online notary can help.