Hesperia, CA · San Bernardino County
Claim for Damages
This form lets a person submit a claim to the City of Hesperia for death, personal injury, or damage to personal or real property.
What this form is
Use this form to present a claim for death, personal injury, or damage to personal or real property to the City of Hesperia. It asks for claimant and notice-contact details, occurrence information, a description of the loss, witnesses, and claim-specific information; the form also identifies filing periods and supporting documents that may apply.
Who needs it
A person seeking to present a claim to the City of Hesperia for death, injury, or property damage should complete and submit this form.
How to submit it
Submit the completed form in person or by mail to the City Clerk’s Office, City of Hesperia, 9700 Seventh Avenue, Hesperia, CA 92345.
About notarization
This document is signed and dated without a notary; applicable medical records, bills, or auto repair documents may be attached, and the claimant signs and dates the claim.
How to submit this form
- 1
Download the Form
Download the City of Hesperia Claim for Damages form.
- 2
Complete the Claim
Fill in the claimant, occurrence, loss, and other applicable claim details requested on the form.
- 3
Gather Supporting Documents
Attach applicable medical records, reports, bills, repair bills, estimates, or similar supporting documents.
- 4
Submit to the City
Submit the completed claim in person or by mail to the City Clerk’s Office at 9700 Seventh Avenue, Hesperia, CA 92345.
Frequently asked questions
- Do I need a notary for the Claim for Damages?
- No. The form calls for the claimant or representative to sign and date it, not for notarization. Supporting medical or auto documents may apply.
- How do I submit the Claim for Damages?
- Submit the completed form in person or by mail to the City Clerk’s Office at 9700 Seventh Avenue, Hesperia, CA 92345.
- What information does the claim form request?
- It asks for claimant and notice-contact details, occurrence circumstances, information about the loss, and details such as witnesses or claim amount when applicable.
- What supporting documents may be attached?
- For applicable claims, the form identifies medical records, reports, bills, or similar documents, and auto repair bills, estimates, or similar documents.
Need something notarized?
This Claim for Damages doesn’t need a notary — but if you have another Hesperia form that does, a commissioned online notary can help.