Do I need a notary for the Palmdale liability claim?

No. The form has no notary block; the signer signs and dates it and declares under penalty of perjury that the information is true and correct.

How do I submit the Palmdale liability claim?

Hand deliver or mail the completed claim to the Palmdale City Clerk at 38300 Sierra Highway, Suite C, Palmdale, CA 93550. Fax and email submissions are not accepted.

What information does the liability claim form request?

It asks for claimant and incident details, the claimed damage or injury, why the city is responsible, and information about witnesses, medical providers, and responding authorities.

What supporting materials may I need to include?

The form requests supporting documentation for claims of $10,000 or less. For motor vehicle accident claims, it asks for proof of insurance; it also includes a scene diagram.

Palmdale, CA · Los Angeles County

No notary required

Liability Claim for Damages to Persons and Personal Property

This claim form is for people seeking compensation from the City of Palmdale for damage to persons or personal property.

What this form is

Use this form to present a claim to the City of Palmdale for personal injury or damage to personal property. It asks for claimant and incident details, a description of the loss and why the city is responsible, and information about witnesses, medical providers, and responding authorities. The form also requests supporting documents when applicable, motor vehicle insurance proof for vehicle claims, and a scene diagram.

Who needs it

People seeking compensation from the City of Palmdale for injury or personal property damage should complete and submit this claim.

How to submit it

Hand deliver or mail the completed claim to Palmdale City Clerk, 38300 Sierra Highway, Suite C, Palmdale, CA 93550. Claims by facsimile or email are not accepted.

About notarization

This claim is signed and dated without a notary; the signer declares under penalty of perjury that the claim information is true and correct.

How to submit this form

1
Download The Claim Form
Download the City of Palmdale liability claim form and its instructions.
2
Complete The Claim
Provide claimant, incident, damage, and other requested information; sign and date the claim.
3
Gather Supporting Materials
Include applicable supporting documentation, motor vehicle insurance proof, and a scene diagram as requested by the form.
4
Submit To The City
Hand deliver or mail the completed claim to the Palmdale City Clerk. The form says fax and email submissions are not accepted.

Frequently asked questions

Do I need a notary for the Palmdale liability claim?: No. The form has no notary block; the signer signs and dates it and declares under penalty of perjury that the information is true and correct.
How do I submit the Palmdale liability claim?: Hand deliver or mail the completed claim to the Palmdale City Clerk at 38300 Sierra Highway, Suite C, Palmdale, CA 93550. Fax and email submissions are not accepted.
What information does the liability claim form request?: It asks for claimant and incident details, the claimed damage or injury, why the city is responsible, and information about witnesses, medical providers, and responding authorities.
What supporting materials may I need to include?: The form requests supporting documentation for claims of $10,000 or less. For motor vehicle accident claims, it asks for proof of insurance; it also includes a scene diagram.

Need something notarized?

This Liability Claim for Damages to Persons and Personal Property doesn’t need a notary — but if you have another Palmdale form that does, a commissioned online notary can help.