Do I need a notary for the Claim Against the City form?

No. The form asks the claimant to sign and date it, without a notary. Attach available bills, estimates, receipts, or additional sheets as needed.

How do I submit the Claim Against the City form?

Return the signed original to the City of Milpitas, Attn: City Clerk, at 455 E. Calaveras Blvd., Milpitas, CA 95035. Attach available bills, estimates, receipts, and any additional sheets.

What information does the claim form ask for?

It asks for claimant and contact information, the incident date, time and location, a description of the incident and damages, and the names of any City employees involved.

What supporting documents can I attach?

The form asks claimants to attach available bills and estimates and allows additional sheets for information that does not fit on the form. It also says to attach receipts as necessary.

Milpitas, CA · Santa Clara County

No notary required

Claim Against the City

This form lets a person submit a claim to the City of Milpitas for damages they believe resulted from a city incident or accident.

What this form is

Use this form to describe an incident or accident, explain why you believe the City is liable, and claim related damages. The form says claims must be filed no later than six months after the incident. It asks for claimant and contact information, incident details, damages, and any City employees involved; attach available bills, estimates, receipts, or additional sheets as needed.

Who needs it

A person seeking damages from the City of Milpitas for an incident or accident they believe made the City liable should complete this claim form.

How to submit it

Return the signed original form to City of Milpitas, Attn: City Clerk, 455 E. Calaveras Blvd., Milpitas, CA 95035. Attach available bills, estimates, receipts, and any additional sheets.

About notarization

This document is signed and dated without a notary; the claimant attaches available bills, estimates, receipts, or additional sheets as needed.

How to submit this form

1
Download the Form
Download the Claim Against the City form.
2
Complete the Claim
Enter your contact information, incident details, reasons you believe the City is liable, and claimed damages.
3
Gather Attachments
Attach available bills, estimates, receipts, and any additional sheets needed to explain the incident or damages.
4
Submit to the City
Sign and date the form, then return the signed original to the City Clerk at the address shown on the form.

Frequently asked questions

Do I need a notary for the Claim Against the City form?: No. The form asks the claimant to sign and date it, without a notary. Attach available bills, estimates, receipts, or additional sheets as needed.
How do I submit the Claim Against the City form?: Return the signed original to the City of Milpitas, Attn: City Clerk, at 455 E. Calaveras Blvd., Milpitas, CA 95035. Attach available bills, estimates, receipts, and any additional sheets.
What information does the claim form ask for?: It asks for claimant and contact information, the incident date, time and location, a description of the incident and damages, and the names of any City employees involved.
What supporting documents can I attach?: The form asks claimants to attach available bills and estimates and allows additional sheets for information that does not fit on the form. It also says to attach receipts as necessary.

Need something notarized?

This Claim Against the City doesn’t need a notary — but if you have another Milpitas form that does, a commissioned online notary can help.