Buena Park, CA · Orange County
Claim for Damages to Persons or Property
This fillable claim form lets people seek compensation from the City of Buena Park for personal injury, property damage, or other losses.
What this form is
Use this form to report an injury or property loss and explain why you believe the City is responsible. It asks for claimant contact details, incident information, witness and medical details, and the amount or type of claim; attach supporting documentation for amounts claimed. The instructions state filing periods of six months for death, personal injury, or personal property claims, and one year for real property claims.
Who needs it
A person seeking compensation from the City of Buena Park for an injury, property damage, or other loss should complete and file this claim.
How to submit it
File the completed form by mail or in person with the City of Buena Park, City Clerk’s Office, 6650 Beach Blvd., Buena Park, CA 90622-5009.
About notarization
No notary is required; the signer certifies the information under penalty of perjury and signs and dates the form.
How to submit this form
- 1
Download The Form
Download the fillable Claim for Damages to Persons or Property form.
- 2
Complete The Claim
Fill in claimant, incident, injury or damage, witness, and claim information. Attach separate sheets if needed to provide full details.
- 3
Gather Supporting Documents
Attach copies of supporting documentation for the amounts claimed.
- 4
Sign And Date The Form
Sign and date the form on page 4; the signer certifies the information under penalty of perjury.
- 5
Submit To The City
Mail or deliver the completed form to the City Clerk’s Office at 6650 Beach Blvd., Buena Park, CA 90622-5009.
Frequently asked questions
- What is the Claim for Damages to Persons or Property?
- It is a City of Buena Park form for reporting personal injury, property damage, or other loss and explaining why the claimant believes the City is responsible.
- Do I need a notary for the Claim for Damages to Persons or Property?
- No. The form has no notary block; the signer certifies the information under penalty of perjury and signs and dates it.
- How do I submit the claim form?
- Mail or deliver the completed form to the City of Buena Park, City Clerk’s Office, 6650 Beach Blvd., Buena Park, CA 90622-5009.
- What information and documents does the form request?
- It asks for claimant and incident details, witnesses, medical information, and claim amounts or case type. Attach copies of supporting documentation for amounts claimed.