Guadalupe, CA · Santa Barbara County
Claim Against the City
This fillable claim form is for people seeking recovery from the City of Guadalupe for an injury, property damage, or other loss.
What this form is
Use this form to present a claim against the City of Guadalupe for an injury, damage to personal property, or another loss. The form says injury and personal-property damage claims must be presented within six months of the loss, while claims for other losses must be presented within one year. It asks for claimant and incident details, losses and requested amount, supporting calculations, and the basis for the claim.
Who needs it
Anyone seeking recovery from the City of Guadalupe for an injury, property damage, or another loss can complete and submit this claim form.
How to submit it
Submit the completed form to the City Administrator at City of Guadalupe, 918 Obispo Street, P.O. Box 908, Guadalupe, CA 93434. The form also lists [email protected].
About notarization
This document is signed and dated without a notary; the claimant declares under penalty of perjury, and no separate notarized attachment is listed.
How to submit this form
- 1
Download The Claim Form
Download the fillable Claim Against the City form.
- 2
Complete The Form
Answer all items fully, providing claimant, incident, loss, and claim amount information.
- 3
Gather Supporting Documents
Attach bills, repair estimates, or receipts used to calculate the amount; for vehicle damage, attach two repair estimates.
- 4
Sign And Date The Form
Sign and date the claimant declaration at the end of the form.
- 5
Submit To The City
Send the completed form to the City Administrator at the Guadalupe address listed on the form.
Frequently asked questions
- What is the Claim Against the City form for?
- It lets a claimant present an injury, personal-property damage, or other loss claim to the City of Guadalupe and provide details and supporting information.
- What information does the claim form request?
- It asks for claimant and incident details, the injury or loss, the amount sought and its calculation, the basis for the claim, and any known city employees or witnesses.
- Do I need a notary for the Claim Against the City form?
- No. The claimant signs and dates the form and declares under penalty of perjury. The form lists no separate notarized attachment.
- How do I submit the Claim Against the City form?
- Send it to the City Administrator, City of Guadalupe, 918 Obispo Street, P.O. Box 908, Guadalupe, CA 93434. The form also lists [email protected].