Republic, WA · Ferry County
Tort-Loss Claim for Damages
This claim form lets a person report losses or expected losses from an incident involving the City of Republic and provide supporting estimates, quotes, or invoices.
What this form is
Use this form to describe an incident and claim losses or expected losses involving the City of Republic. It asks for claimant and incident details, a full account of what happened, itemized losses, information about other people and witnesses, and whether the claimant is willing to settle. The form says attachments containing medical information should be enclosed in a sealed envelope marked with the claimant’s name and “Medical Contents.”
Who needs it
A person seeking damages from the City of Republic for losses connected to an incident can use this form to provide claim details and supporting documentation.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is completed without a notary; it identifies no sworn or notarized attachments, and asks the claimant to provide claim information.
How to submit this form
- 1
Download the Form
Download the Tort-Loss Claim for Damages form.
- 2
Complete the Claim
Provide claimant and incident details, describe what happened, itemize losses, and answer the questions about other people, witnesses, and settlement.
- 3
Gather Supporting Documents
Include formal estimates, quotes, or invoices. Enclose any attachments containing medical information in a sealed envelope marked with your name and “Medical Contents.”
- 4
Submit to the City
Submit the completed claim to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Tort-Loss Claim for Damages form?
- It is a City of Republic form for describing an incident and listing specific losses sustained or expected, with estimates, quotes, or invoices requested as support.
- Who should use this claim form?
- A person making a claim for damages involving the City of Republic can use it to provide claimant details, an incident account, itemized losses, and information about others involved or witnesses.
- Do I need a notary for the Tort-Loss Claim for Damages?
- No. The document has no notary block or notarized attachment step; it asks the claimant to provide claim information.
- How do I submit the Tort-Loss Claim for Damages?
- The form does not specify how to submit it. Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Tort-Loss Claim for Damages doesn’t need a notary — but if you have another Republic form that does, a commissioned online notary can help.