Who can use the Huntington Beach claim form?

A person claiming injury or personal property damage allegedly caused by the City of Huntington Beach or its employees can use this form.

What information does the claim form request?

It requests claimant and incident details, information about the injury or property damage, the amounts claimed, supporting bills or estimates, and investigation details.

How do I submit the Huntington Beach claim form?

Mail or deliver the completed claim to the City Clerk at 2000 Main Street, P.O. Box 190, Huntington Beach, California 92648.

Do I need a notary for the Huntington Beach claim form?

No. The claimant signs and dates a certification under penalty of perjury; the form does not specify a notarized attachment or related step.

Huntington Beach, CA · Orange County

No notary required

Claim Against the City for Damages to Persons or Personal Property

This claim form is for people seeking compensation from the City of Huntington Beach for injury or personal property damage allegedly caused by the City or its employees.

What this form is

Use this form to file a claim against the City of Huntington Beach for injury or personal property damage. The form says to file with the City Clerk within six months after the incident or event. It asks for claimant and incident details, a description of the injury or loss, claimed damages and supporting bills or estimates, and information that may help investigate the claim.

Who needs it

Anyone claiming personal injury or personal property damage caused by the City of Huntington Beach or its employees can use this form.

How to submit it

Mail or deliver the completed claim to the City Clerk, City of Huntington Beach, 2000 Main Street, P.O. Box 190, Huntington Beach, California 92648.

About notarization

This document is signed without a notary; the claimant signs and dates a certification under penalty of perjury, and no notarized attachment or related step is specified.

How to submit this form

1
Download The Claim Form
Download the City of Huntington Beach claim form.
2
Complete The Claim Sections
Provide claimant, incident, injury or damage, and claimed amount details.
3
Gather Supporting Documents
Include copies of bills, invoices, receipts, and estimates supporting the amounts claimed.
4
Sign And Date The Form
Sign and date the claimant certification under penalty of perjury.
5
Submit To The City Clerk
Mail or deliver the claim to the City Clerk at the address provided on the form.

Frequently asked questions

Who can use the Huntington Beach claim form?: A person claiming injury or personal property damage allegedly caused by the City of Huntington Beach or its employees can use this form.
What information does the claim form request?: It requests claimant and incident details, information about the injury or property damage, the amounts claimed, supporting bills or estimates, and investigation details.
How do I submit the Huntington Beach claim form?: Mail or deliver the completed claim to the City Clerk at 2000 Main Street, P.O. Box 190, Huntington Beach, California 92648.
Do I need a notary for the Huntington Beach claim form?: No. The claimant signs and dates a certification under penalty of perjury; the form does not specify a notarized attachment or related step.

Need something notarized?

This Claim Against the City for Damages to Persons or Personal Property doesn’t need a notary — but if you have another Huntington Beach form that does, a commissioned online notary can help.