Calimesa, CA · Riverside County
Liability Claim Form
The Liability Claim Form lets a claimant or someone acting on their behalf present a claim to the City of Calimesa.
What this form is
Use this form to present a claim to the City of Calimesa; the document says the form is provided for convenience and is not required if you submit a written claim that meets the stated requirements. It asks for claimant and notice-contact details, information about the occurrence, a description of the loss, the amount claimed and its calculation, and a signature.
Who needs it
A claimant, or a person acting on the claimant’s behalf, may use this form to present a claim to the City of Calimesa.
How to submit it
Return the completed form and any attachments to the City Clerk, City of Calimesa, 908 Park Avenue, Calimesa, California 92320.
About notarization
This form is signed and dated without a notary; it mentions optional attachments but no sworn or notarized step.
How to submit this form
- 1
Download the Form
Download the Liability Claim Form PDF.
- 2
Complete the Form
Answer all questions, print legibly, and use the back if you need more space.
- 3
Gather Attachments
Include any attachments you want to submit with the completed form.
- 4
Submit to the City Clerk
Return the form and any attachments to the City Clerk at the address listed on the form.
Frequently asked questions
- What information does the Liability Claim Form ask for?
- It asks for claimant and notice-contact details, the date and place of the occurrence, what happened, the loss or damage, the amount claimed and its calculation, and a signature.
- How do I submit the Liability Claim Form?
- Return the completed form and any attachments to the City Clerk, City of Calimesa, 908 Park Avenue, Calimesa, California 92320.
- Do I need a notary for the Liability Claim Form?
- No. The form is signed and dated without a notary. It mentions optional attachments but does not describe a sworn or notarized step.
- Is this form required to present a claim?
- No. The form says it is provided for convenience and that a written claim meeting the requirements stated on the form may be submitted instead.
Need something notarized?
This Liability Claim Form doesn’t need a notary — but if you have another Calimesa form that does, a commissioned online notary can help.