Mammoth Lakes, CA · Mono County
Claim for Damages Form
Claimants use this form to submit a claim to the Town of Mammoth Lakes for injury, property damage, or another loss they attribute to the Town or its employees.
What this form is
Use this form to present a claim to the Town for personal injury, damage to personal property, or another loss. The instructions say injury and personal-property claims must be presented within six months of the loss, and other claims within one year. The form asks for incident details, losses and estimated damages, the claimant’s basis for the claim, witnesses, supporting documentation, and a signed declaration.
Who needs it
Anyone seeking to make a claim against the Town for injury, property damage, or another loss should complete and submit this form.
How to submit it
Send the completed form to Jamie Gray, Town Clerk, P.O. Box 1609, Mammoth Lakes, CA 93546. The form also lists 760-965-3602 and [email protected].
About notarization
This document is signed without a notary; the claimant declares the claim under penalty of perjury and signs and dates it.
How to submit this form
- 1
Download the Form
Download the Town of Mammoth Lakes Claim for Damages Form.
- 2
Complete the Claim
Answer all items fully, including information about the loss, damages, witnesses, and the basis for your claim.
- 3
Gather Supporting Materials
Attach any additional pages and copies of receipts, estimates, bills, invoices, or other documentation; provide a picture and scene sketch as requested.
- 4
Sign and Submit
Sign and date the declaration, then send the form to the Town Clerk at the address provided on the form.
Frequently asked questions
- Do I need a notary for the Claim for Damages Form?
- No. The form has no notary block; the claimant signs and dates a declaration under penalty of perjury.
- How do I submit the Claim for Damages Form?
- Mail it to Jamie Gray, Town Clerk, P.O. Box 1609, Mammoth Lakes, CA 93546. The form also lists an email address and phone number.
- What information does the claim form request?
- It asks for claimant and incident details, injury or loss, damages, the basis for the claim, witnesses, and supporting materials such as receipts or repair estimates.
- When must I present a claim?
- The instructions state that injury or personal-property damage claims must be presented within six months of the loss; other claims must be presented within one year.
Need something notarized?
This Claim for Damages Form doesn’t need a notary — but if you have another Mammoth Lakes form that does, a commissioned online notary can help.