Wasco, CA · Kern County
Claim Against the City
This form lets a person or representative submit a claim to the City of Wasco for injury, property damage, or loss allegedly caused by the city.
What this form is
Use this form to present a claim against the City of Wasco for an incident, injury, property damage, or other loss. The form says claims related to an accident, event, or incident must be filed with the City Clerk within six months; other claims may have different filing times. It requests claimant details, incident circumstances, injury or loss, city employee information, damages, and witness contacts.
Who needs it
A person seeking compensation from the City of Wasco, or someone acting on that claimant’s behalf, should complete and file this form.
How to submit it
Mail or deliver the completed form to the City Clerk, City of Wasco, at 746 8th St, Wasco, CA 93280; the form requires filing within six months for accident, event, or incident claims.
About notarization
No notary is required; the claimant or representative signs and dates the form and 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 Wasco claim form PDF.
- 2
Complete the Form
Provide claimant and incident details, describe the injury or loss, list damages and witnesses, and sign and date the form.
- 3
Gather Supporting Documents
Attach supporting bills, invoices, or repair estimates. For property damage, include copies of two separate repair estimates.
- 4
Submit to the City Clerk
Mail or deliver the completed form to the City Clerk at 746 8th St, Wasco, CA 93280.
Frequently asked questions
- Do I need a notary for the City of Wasco claim form?
- No. The claimant or representative signs and dates the form and declares under penalty of perjury that the information is true and correct.
- How do I submit a claim against the City of Wasco?
- Mail or deliver the completed form to the City Clerk at 746 8th St, Wasco, CA 93280. The form says accident, event, or incident claims must be filed within six months.
- What information does the claim form request?
- It asks for claimant details, the incident date, time and location, the basis of the claim, injury or loss details, city employee information, damages, and witness contacts.
- What attachments should I include with a property damage claim?
- The form requests supporting documents such as invoices and repair estimates, and says to provide copies of two separate repair estimates for property damage.
Need something notarized?
This Claim Against the City doesn’t need a notary — but if you have another Wasco form that does, a commissioned online notary can help.