Larkspur, CA · Marin County
Claim Form
The City of Larkspur Claim Form lets a claimant describe an incident and request money for resulting injury, damage, or loss.
What this form is
Use this form to make a claim against an entity for an incident or accident involving injury, damage, or loss. It asks for claimant and incident details, what caused the loss, any known employees involved, the specific losses, the amount sought and how it was calculated, plus the claimant’s signature and date. Use a separate sheet or the back if more room is needed.
Who needs it
A person seeking money for injury, damage, or loss related to an incident or accident involving an entity can use this form to state the claim.
How to submit it
The form lists the City of Larkspur at 400 Magnolia Avenue, Larkspur, CA 94939, and telephone (415) 927-5110. It does not specify a submission method.
About notarization
This document is signed and dated without a notary; it mentions no notarized or sworn attachment or related step.
How to submit this form
- 1
Download The Form
Download the City of Larkspur Claim Form.
- 2
Complete The Claim Details
Type or print the claimant, incident, loss, and amount information requested on the form.
- 3
Add Extra Details If Needed
Use the back of the form or a separate sheet for detailed answers where the form allows.
- 4
Sign And Date
Provide the date signed and the claimant’s signature; include representative details if signed by a representative.
- 5
Submit To The City
The form lists the City of Larkspur at 400 Magnolia Avenue, Larkspur, CA 94939; it does not specify a submission method.
Frequently asked questions
- What information does the Larkspur Claim Form ask for?
- It asks for claimant contact details, incident dates and location, what caused the loss, known employees involved, the injuries or losses, the amount sought and how it was calculated, and a signature and date.
- Do I need a notary for the Larkspur Claim Form?
- No. The form has a signature and date line but no notary block. It does not mention a notarized or sworn attachment or related step.
- How do I submit the Larkspur Claim Form?
- The form lists the City of Larkspur at 400 Magnolia Avenue, Larkspur, CA 94939, and telephone (415) 927-5110, but does not state how to submit the form.
- Can I include extra details with the claim?
- Yes. The form says to use its back or a separate sheet if necessary to describe what caused the loss, the specific injuries or damages, or how the amount sought was calculated.
Need something notarized?
This Claim Form doesn’t need a notary — but if you have another Larkspur form that does, a commissioned online notary can help.