Jurupa Valley, CA · Riverside County
Claim for Money or Damages Against the City of Jurupa Valley
Claimants use this form to present a claim for money or damages against the City of Jurupa Valley and provide details about the incident and losses.
What this form is
This form presents a claim for money or damages against the City of Jurupa Valley. It asks for claimant and notice-contact details, information about the occurrence, the injury or loss, witnesses, and supporting information such as medical or vehicle records when applicable. The form states that claims for death, personal injury, personal property, or growing crops must be presented within six months; other claims within one year.
Who needs it
A person seeking money or damages from the City of Jurupa Valley for an occurrence or transaction uses this form to present the claim.
How to submit it
Personally deliver or mail the completed claim to the City Clerk Department, City of Jurupa Valley, 8930 Limonite Avenue, Jurupa Valley, CA 92509-5183.
About notarization
This document is signed and dated without a notary; sign, date, and number attachments, and sign any attached diagram.
How to submit this form
- 1
Download the Claim Form
Download the City of Jurupa Valley claim for money or damages form.
- 2
Complete the Claim
Fill in claimant and contact information, incident details, and information about the loss and any witnesses.
- 3
Gather Attachments
If applicable, attach supporting medical or vehicle documents. Sign, date, and number attachments; sign any attached diagram.
- 4
Submit to the City
Personally deliver or mail the completed claim to the City Clerk Department at the address printed on the form.
Frequently asked questions
- Do I need a notary for the claim for money or damages?
- No. This document is signed and dated without a notary. Sign, date, and number any attachments, and sign any attached diagram.
- How do I submit the claim for money or damages?
- Personally deliver or mail it to the City Clerk Department, City of Jurupa Valley, 8930 Limonite Avenue, Jurupa Valley, CA 92509-5183.
- What information does the claim form ask for?
- It asks for claimant and notice-contact details, incident circumstances, the injury or loss, witnesses, and additional medical or vehicle information when applicable.
- What supporting documents can I attach?
- For a medical-treatment claim, the form says to attach applicable medical records, reports, bills, or similar documents. For an automobile claim, it mentions repair bills, estimates, or similar documents.
Need something notarized?
This Claim for Money or Damages Against the City of Jurupa Valley doesn’t need a notary — but if you have another Jurupa Valley form that does, a commissioned online notary can help.