San Jacinto, CA · Riverside County
Claim for Money or Damages Against the City of San Jacinto
This claim form is for people seeking money or damages from the City of San Jacinto for an injury, loss, or other cause of action.
What this form is
Use this form to present a claim for money or damages against the City of San Jacinto. It asks for claimant and notice-contact details, information about the occurrence, the injury or loss, and supporting details such as witnesses or medical treatment. The form states that injury, death, personal-property, or growing-crop claims must be presented within six months; other claims within one year.
Who needs it
A person seeking money or damages from the City of San Jacinto should complete this form with details about the claim and any applicable supporting information.
How to submit it
Personally deliver or mail the claim to Julia Espinoza, City Clerk, City of San Jacinto, 595 S. San Jacinto Avenue, San Jacinto, CA 92583.
About notarization
This document is signed and dated without a notary; the claimant or representative signs and dates the claim and any attached sheets.
How to submit this form
- 1
Download The Form
Download the City of San Jacinto claim form.
- 2
Complete The Claim
Provide the requested claimant, occurrence, injury or loss, and other applicable claim details.
- 3
Gather Attachments
Attach any applicable supporting records, bills, estimates, or diagrams; sign, date, and number attached sheets.
- 4
Sign And Date
Sign and date the claim as the claimant or a person acting on the claimant’s behalf.
- 5
Submit To The City Clerk
Personally deliver or mail the completed claim to the City Clerk at the address listed on the form.
Frequently asked questions
- Do I need a notary for the San Jacinto claim form?
- No. The form calls for the claimant or representative to sign and date it, without a notary. Sign, date, and number any attached sheets.
- How do I submit the San Jacinto claim form?
- Personally deliver or mail it to Julia Espinoza, City Clerk, City of San Jacinto, 595 S. San Jacinto Avenue, San Jacinto, CA 92583.
- What information does the claim form request?
- It asks for claimant and notice-contact details, occurrence information, a description of the injury or loss, and other details such as witnesses and, when applicable, medical or vehicle information.
- When does the form say a claim must be presented?
- The form states that claims involving death, personal injury, personal property, or growing crops must be presented within six months of accrual; other claims within one year.
