How do I submit the Claim Form?

Mail or deliver the completed form to the City Clerk, City of Dana Point, 33282 Golden Lantern #203, Dana Point, CA 92629.

What information does the Claim Form ask for?

It asks about the incident, the damage or injury, city employees involved, witnesses, and the amount claimed. It also requests supporting bills, invoices, or estimates.

Dana Point, CA · Orange County

No notary required

Claim Form

Claimants use this form to report personal injury or personal property damage and submit a claim to the City of Dana Point.

What this form is

Use this form to submit a claim against the City of Dana Point for damage to a person or personal property. The form says a claim must be filed with the City Clerk within six months after the incident or event. It asks when, where, and how the damage occurred, requests details about injuries and losses, and provides space to list claimed damages and supporting bills, invoices, or estimates.

Who needs it

Anyone seeking to submit a claim against the City of Dana Point for personal injury or personal property damage should complete this form.

How to submit it

Mail or deliver the completed claim to the City Clerk, City of Dana Point, 33282 Golden Lantern #203, Dana Point, CA 92629.

About notarization

This document is signed without a notary; the claimant signs and dates it and certifies under penalty of perjury that the statements are true and correct.

How to submit this form

1
Download The Form
Download the City of Dana Point Claim Form.
2
Complete The Form
Provide claimant contact details and information about when, where, and how the damage or injury occurred.
3
Gather Supporting Documents
Include copies of bills, invoices, estimates, and other helpful information about the claim.
4
Submit To The City
Mail or deliver the completed claim to the City Clerk at the address listed on the form.

Frequently asked questions

Do I need a notary for the Claim Form?: No. The claimant signs and dates the form and certifies under penalty of perjury that the statements are true and correct; no notary block is provided.
How do I submit the Claim Form?: Mail or deliver the completed form to the City Clerk, City of Dana Point, 33282 Golden Lantern #203, Dana Point, CA 92629.
What information does the Claim Form ask for?: It asks about the incident, the damage or injury, city employees involved, witnesses, and the amount claimed. It also requests supporting bills, invoices, or estimates.
When must I file a claim?: The form says a claim must be filed with the City Clerk within six months after the incident or event occurred.

Need something notarized?

This Claim Form doesn’t need a notary — but if you have another Dana Point form that does, a commissioned online notary can help.