Richmond, CA · Contra Costa County
Claim Against the City
This claim form lets people report alleged injury or property damage and request compensation from the City of Richmond.
What this form is
Use this form to present a claim against the City of Richmond for alleged injury, property damage, or other loss. The instructions describe presentation periods based on the type of claim and say to explain why a claim is late if applicable. The form asks for incident details, the claimant’s information and signature, witnesses, and the amount claimed or case type.
Who needs it
Anyone seeking compensation from the City of Richmond for alleged injury, property damage, or another loss may use this form.
How to submit it
Send the original claim to the City Clerk, 450 Civic Center Plaza, 3rd Floor, Richmond, CA 94804. The form also lists fax number (707) 428-7631.
About notarization
This document is signed without a notary; the claimant declares under penalty of perjury that the information is true and correct.
How to submit this form
- 1
Download the Claim Form
Download the City of Richmond claim form and read its instructions before completing it.
- 2
Complete Each Section
Type or print clearly, provide the requested incident and claim details, and sign and date the form.
- 3
Gather Supporting Documents
Attach copies of available bills, payment receipts, and cost estimates, and make copies for your records.
- 4
Send It to the City Clerk
Send the original claim to the City Clerk at 450 Civic Center Plaza, 3rd Floor, Richmond, CA 94804.
Frequently asked questions
- Do I need a notary for the City of Richmond claim form?
- No. The document does not require a notary; the claimant signs and declares under penalty of perjury that the information is true and correct.
- How do I submit a claim against the City of Richmond?
- Send the original claim to the City Clerk at 450 Civic Center Plaza, 3rd Floor, Richmond, CA 94804. The document also lists a fax number.
- What information does the claim form ask for?
- It asks for claimant contact details, where and when the incident occurred, circumstances and damage, the amount claimed, witnesses, and a signature.
- What should I attach to the claim?
- The instructions say to attach copies of available bills, payment receipts, and cost estimates. They also say to make and keep your own copies.
Need something notarized?
This Claim Against the City doesn’t need a notary — but if you have another Richmond form that does, a commissioned online notary can help.