Willits, CA · Mendocino County
Claim For Money Or Damages Against The City Of Willits
This form lets a claimant or someone acting on their behalf present a claim for money or damages against the City of Willits.
What this form is
Use this form to present a claim for money or damages against the City of Willits. It asks for the claimant’s contact information, details about the incident and loss, and information about the amount claimed; additional questions cover witnesses and, when applicable, medical treatment or automobile accidents.
Who needs it
A person seeking money or damages from the City of Willits, or someone presenting a claim on that person’s behalf, can use this form.
How to submit it
File the completed claim with the City of Willits, 111 E Commercial Street, Willits, CA 95490. The form does not list an email or online submission option.
About notarization
This document is signed and dated without a notary; the form does not identify any attachment or related step as requiring notarization or a sworn statement.
How to submit this form
- 1
Download The Form
Download the Claim For Money Or Damages Against The City Of Willits form.
- 2
Complete The Claim
Provide the requested claimant, incident, loss, and other applicable information.
- 3
Gather Attachments
Attach extra sheets if needed and supporting medical or automobile documents when applicable.
- 4
Sign And Date
Sign and date the claim form.
- 5
File With The City
File the completed claim with the City of Willits at the address listed on the form.
Frequently asked questions
- Do I need a notary for the Willits claim form?
- No. The form provides a signature and date line but does not require notarization. It does not identify any attachment or related step as notarized or sworn.
- How do I submit the claim form?
- File the completed form with the City of Willits at 111 E Commercial Street, Willits, CA 95490. The form does not list an email or online submission option.
- What information does the claim form ask for?
- It asks for claimant and notice contact details, incident circumstances, the claimed loss, and known witnesses. It also has questions about medical treatment and automobile accidents when applicable.
- Can I attach supporting documents?
- Yes. The form says to attach extra sheets if more space is needed, and requests supporting medical bills, reports, repair bills, estimates, or similar documents when applicable.