Des Moines, WA · King County
Claim for Damages
The Claim for Damages form lets a person or authorized representative request compensation from the City of Des Moines for an injury or property damage and submit supporting information and evidence.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Use this form to describe the circumstances, injury or damage, and amount claimed from the City of Des Moines. Include requested contact and incident details, witness information if applicable, and copies of supporting records, bills, photographs, receipts, or repair estimates. Automobile claimants must also complete the vehicle section. The instructions require the claimant or authorized representative to sign and notarize the form, then submit the original and supporting documents in person or by mail.
Who needs it
A person seeking damages from the City of Des Moines, or an authorized representative filing on the claimant’s behalf, must complete and submit this form.
Why it needs a notary
The form carries an acknowledgment block; the claimant or authorized representative signs the claim and acknowledges the signature before the notary.
How to get this notarized
- 1
Download the Form
Get the City of Des Moines Claim for Damages form and its completion instructions.
- 2
Complete the Claim
Provide the requested claimant, incident, and damage details. Add witness and automobile information when applicable, and attach supporting documents.
- 3
Book an Online Notary
Arrange a remote online notarization with a commissioned online notary.
- 4
Sign on Video
Follow the notary’s instructions to sign and acknowledge the claim during the online video session.
- 5
Submit to the City
Mail or deliver the original notarized form and supporting documents to the City Clerk. The city does not accept email or fax submissions.
Preview the form
The blank PDF straight from Des Moines. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I submit a Des Moines claim for damages?
- Complete and sign the form, have your signature notarized, and include supporting documents. The city says to mail or deliver the original claim and documents to the City Clerk; email and fax submissions are not accepted.
- Do I need to have my claim for damages notarized?
- Yes. The form instructions say the claim must be signed and notarized. Its notarial block asks the signer to acknowledge the signature as a free and voluntary act.
- Can I sign this claim with a commissioned online notary?
- Washington authorizes remote online notarization for its own notaries under RCW 42.45.280. Ask the City of Des Moines whether it will accept a remotely notarized original for this claim; confirm with the city or town if unsure.
- What documents should I include with my claim?
- Include available documents supporting the claim, such as medical records, bills, photographs, proof of property ownership, receipts, and records of expenses, injuries, losses, or repair estimates.
Claim for Damages in other King County cities
Each city publishes its own version of this form. Pick the city where you’re filing.