Buellton, CA · Santa Barbara County
Claim for Money or Damages Against the City
This form lets a claimant or someone acting on their behalf present a claim for money or damages against the City of Buellton.
What this form is
Use this form to present a claim for money or damages against the City of Buellton. It asks for claimant and notice contact details, information about the incident and resulting loss, and the amount or type of civil case claimed. Additional questions cover witnesses, medical treatment, and automobile insurance; claimants may attach supporting bills, reports, estimates, or a signed accident diagram.
Who needs it
A person seeking money or damages from the City of Buellton, or someone acting on that claimant’s behalf, uses this form to present the claim.
How to submit it
File the completed claim with the City Clerk’s Office, as directed on the form.
About notarization
This document is signed and dated without a notary; it also allows supporting bills, reports, estimates, or a signed diagram to be attached.
How to submit this form
- 1
Download The Form
Download the City of Buellton claim form.
- 2
Complete The Claim
Provide claimant and notice contact details, incident circumstances, information about the loss, and the claim amount or civil case type requested.
- 3
Gather Supporting Documents
Attach any applicable medical bills or reports, repair bills or estimates, additional information sheets, or a signed diagram.
- 4
Sign And Submit
Sign and date the form, then file it with the City Clerk’s Office as directed on the form.
Frequently asked questions
- What is the Buellton liability claim form for?
- It is used to present a claim for money or damages against the City of Buellton. The form requests claimant, incident, loss, and claim amount or case-type information.
- Do I need a notary for the liability claim form?
- No. The document provides a signature and date line, but no notary block. Supporting bills, reports, estimates, or a signed diagram may be attached.
- How do I submit the liability claim form?
- The form says to file the claim with the City Clerk’s Office. It does not provide a submission email or portal.
- What supporting information can I attach?
- The form allows additional sheets and, when applicable, medical bills or reports, vehicle repair bills or estimates, and a signed diagram if the printed diagrams do not fit.