El Monte, CA · Los Angeles County
Claim for Damages Form
Claimants use this form to report property damage or other injury and request damages from the City of El Monte.
What this form is
This form lets a claimant describe property damage or another injury they believe was caused by a City act or omission. It asks for claimant contact details, when and where the incident occurred, the damage or injuries, the amount claimed, insurance payments, expenses, witnesses, and a diagram; the claimant signs a declaration that the information is true and correct.
Who needs it
Anyone seeking damages from the City for property damage or another injury can use this form to present a claim.
How to submit it
File the completed claim with the City Clerk. Sign the reverse side and every attached sheet, and include the accident diagram requested by the form.
About notarization
This document is signed without a notary; it includes a declaration under penalty of perjury, and claimants may be required to be examined under oath.
How to submit this form
- 1
Download The Form
Download the Claim for Damages Form PDF.
- 2
Complete The Claim
Provide claimant details and describe when, where, and how the damage or injury occurred, along with the amount claimed.
- 3
Gather Attachments
Complete the diagram and attach any additional sheets needed; sign the reverse side and every attached sheet.
- 4
File With The City
File the completed claim with the City Clerk.
Frequently asked questions
- What is the Claim for Damages Form used for?
- It lets a claimant describe property damage or another injury, explain the claimed cause, provide supporting details, and state the damages being requested from the City.
- Do I need a notary for the Claim for Damages Form?
- No. The form has no notary block; the claimant signs a declaration under penalty of perjury, and claimants may be required to be examined under oath.
- How do I submit the Claim for Damages Form?
- File it with the City Clerk. Sign the reverse side and each attached sheet, and complete the incident diagram requested by the form.
Need something notarized?
This Claim for Damages Form doesn’t need a notary — but if you have another El Monte form that does, a commissioned online notary can help.