Eureka, CA · Humboldt County
Claim for Money or Damages Against the City of Eureka
This form lets a person or someone acting on their behalf submit a claim for money or damages against the City of Eureka.
What this form is
Use this form to present a claim for money or damages against the City of Eureka. It requests claimant and notice contact details, information about the occurrence and resulting loss, and other details such as witnesses, medical treatment, or vehicle insurance when relevant. It also asks for supporting documents when applicable and a signature and date.
Who needs it
A person seeking money or damages from the City of Eureka, or someone acting on that person’s behalf, uses this form to present a claim.
How to submit it
File it with the City of Eureka, 531 “K” Street, Eureka, CA 95501, Attention: City Clerk; this filing address is printed on the form.
About notarization
This claim is signed and dated without a notary; medical, repair, or diagram attachments may be included when applicable, but no notarized or sworn attachment is identified.
How to submit this form
- 1
Download The Claim Form
Download the City of Eureka Claim for Money or Damages Against the City of Eureka PDF.
- 2
Complete The Claim Details
Provide claimant and notice contact information, occurrence details, the claimed loss, and other applicable information requested on the form.
- 3
Gather Applicable Attachments
Include medical bills or reports, repair bills or estimates, or a signed diagram when applicable.
- 4
Sign And Date The Form
Sign and date the claim on page 3.
- 5
File With The City Clerk
File it with the City of Eureka, 531 “K” Street, Eureka, CA 95501, Attention: City Clerk.
Frequently asked questions
- What is the Claim for Damages form used for?
- It is used to present a claim for money or damages against the City of Eureka and provide information about the occurrence and claimed loss.
- Who can present a claim?
- The form says a claim may be presented by the claimant or a person acting on the claimant’s behalf.
- How do I submit the Claim for Damages form?
- File it with the City of Eureka, 531 “K” Street, Eureka, CA 95501, Attention: City Clerk, as stated on the form.
- Do I need a notary for the Claim for Damages form?
- No. The claim requires a signature and date, not notarization. Medical, repair, or diagram attachments may be included when applicable; the form does not identify any notarized or sworn attachment.