How do I submit the claim form?

Return the completed form to the City Clerk at 250 N. Ventura Road, Port Hueneme, CA 93041. Include supporting bills, estimates, or receipts as applicable.

What information does the claim form ask for?

It asks for claimant contact information, incident details, the injury or loss, the amount sought, its calculation, and information about witnesses or involved city employees.

When does the city require a claim to be presented?

The form states that claims for injury or personal property damage must be presented within six months of the loss, and claims for other losses within one year.

Port Hueneme, CA · Ventura County

No notary required

Notice Of Claim Against The City Of Port Hueneme

This form lets a claimant notify the City of Port Hueneme of an injury, property damage, or other loss and request compensation.

What this form is

Claimants use this form to present a claim against the City of Port Hueneme for injury, personal property damage, or another loss. The form says injury and property damage claims must be presented within six months of the loss, while other claims must be presented within one year. It asks for incident details, the loss and amount sought, supporting information, and claimant contact details.

Who needs it

Anyone seeking compensation from the City of Port Hueneme for an injury, property damage, or other loss can use this claim form.

How to submit it

Return the completed form to the City Clerk, City of Port Hueneme, 250 N. Ventura Road, Port Hueneme, CA 93041. Attach supporting bills, estimates, or receipts as applicable.

About notarization

This claim is signed without a notary; the claimant or representative signs and dates the declaration under penalty of perjury.

How to submit this form

1
Download The Claim Form
Download the City of Port Hueneme Notice of Claim form.
2
Complete The Claim Details
Fill in claimant and incident information, describe the loss, and state the amount sought and how it was calculated.
3
Gather Supporting Documents
Attach bills, repair estimates, or receipts as applicable; the form requests two repair estimates for vehicle damage.
4
Sign And Date The Form
The claimant or person presenting the claim signs and dates the declaration under penalty of perjury.
5
Return The Form To The City Clerk
Send the completed form to the City Clerk at 250 N. Ventura Road, Port Hueneme, CA 93041.

Frequently asked questions

Do I need a notary for this claim form?: No. The claimant or representative signs and dates the declaration under penalty of perjury; the form does not require a notary.
How do I submit the claim form?: Return the completed form to the City Clerk at 250 N. Ventura Road, Port Hueneme, CA 93041. Include supporting bills, estimates, or receipts as applicable.
What information does the claim form ask for?: It asks for claimant contact information, incident details, the injury or loss, the amount sought, its calculation, and information about witnesses or involved city employees.
When does the city require a claim to be presented?: The form states that claims for injury or personal property damage must be presented within six months of the loss, and claims for other losses within one year.

Need something notarized?

This Notice Of Claim Against The City Of Port Hueneme doesn’t need a notary — but if you have another Port Hueneme form that does, a commissioned online notary can help.