What is the Claim for Damages to Person or Property form?

It is a form for presenting a claim for injury or property damage to the entity named on the form. It collects information about the incident, responsibility, witnesses, and damages.

Who should complete this damages claim form?

A person seeking damages for an injury or property damage can use the form to provide claimant and incident details and state the amount claimed.

Do I need a notary for the Claim for Damages to Person or Property form?

No. The claimant signs and dates the form without a notary. Any attached detail sheets must also be signed.

How do I submit the damages claim form?

File the signed claim with the Clerk or governing board, as stated on the form. The form does not give an address, email, or online submission option.

Winters, CA · Yolo County

No notary required

Claim for Damages to Person or Property

This claim form lets a person seeking compensation for injury or property damage provide details and submit a claim to the named entity.

What this form is

Use this form to present a claim for injury to a person, personal property, or real property to the entity named on the form. It asks for claimant contact details, when and where the damage occurred, what happened, why the entity is responsible, and claimed damages. The form states filing deadlines of six months for death, personal injury, or personal property claims and one year for real property claims.

Who needs it

A person seeking damages for an injury or property damage who is filing a claim with the entity named on the form needs this document.

How to submit it

File the signed claim with the Clerk or governing board, as stated on the form; it does not provide an address, email, or portal.

About notarization

This document is signed without a notary; the claimant signs and dates it, and any attached detail sheets must also be signed.

How to submit this form

1
Download The Claim Form
Download the Claim for Damages to Person or Property PDF.
2
Complete The Claim Details
Fill in claimant information, incident details, witnesses, medical information, and damages claimed.
3
Gather And Sign Attachments
Attach and sign separate detail sheets if needed; sign an additional diagram if the form's diagrams do not fit the situation.
4
File The Signed Claim
File the signed claim with the Clerk or governing board, as stated on the form.

Frequently asked questions

What is the Claim for Damages to Person or Property form?: It is a form for presenting a claim for injury or property damage to the entity named on the form. It collects information about the incident, responsibility, witnesses, and damages.
Who should complete this damages claim form?: A person seeking damages for an injury or property damage can use the form to provide claimant and incident details and state the amount claimed.
Do I need a notary for the Claim for Damages to Person or Property form?: No. The claimant signs and dates the form without a notary. Any attached detail sheets must also be signed.
How do I submit the damages claim form?: File the signed claim with the Clerk or governing board, as stated on the form. The form does not give an address, email, or online submission option.

Need something notarized?

This Claim for Damages to Person or Property doesn’t need a notary — but if you have another Winters form that does, a commissioned online notary can help.