Ellensburg, WA · Kittitas County
Claim for Damages
The City of Ellensburg Tort Claim Form lets a claimant submit a claim to the city for injury or property damages.
What this form is
Use this form to file a tort claim against the City of Ellensburg. It requests claimant and incident details, names of people with relevant knowledge, information about injuries or property loss, supporting documents, and the amount of damages claimed. Complete and sign the form, attach available supporting evidence, and submit the original to the Office of the City Clerk; electronic submission by email or fax is not accepted.
Who needs it
A person seeking damages from the City of Ellensburg for an incident involving injury or property loss should complete and submit this form.
How to submit it
Mail or deliver the original claim to the Office of the City Clerk at Ellensburg City Hall, 501 North Anderson Street, Ellensburg, WA 98926-7054. The form says claims cannot be submitted by email or fax.
About notarization
This document is signed without a notary, but the claimant declares under penalty of perjury that the information is true and correct and signs and dates the form.
How to submit this form
- 1
Download The Form
Download the City of Ellensburg Claim for Damages and read the instructions and form in their entirety.
- 2
Complete The Form
Type or print clearly in ink and provide the requested claimant, incident, witness, injury, and damages information.
- 3
Gather Supporting Documents
Attach available evidence supporting your claim, such as medical records or bills, photographs, proof of ownership, or receipts.
- 4
Sign And Submit
Sign and date the form, then mail or deliver the original to the Office of the City Clerk. Do not submit it by email or fax.
Frequently asked questions
- Do I need a notary for the Ellensburg Claim for Damages?
- No. The form does not require a notary. The claimant signs and dates it and declares under penalty of perjury that the information is true and correct.
- How do I submit the Ellensburg Claim for Damages?
- Mail or deliver the original to the Office of the City Clerk at Ellensburg City Hall, 501 North Anderson Street, Ellensburg, WA 98926-7054. Email and fax submissions are not accepted.
- What information does the claim form request?
- It asks for claimant and incident details, information about witnesses and city employees with knowledge, injury or property damage information, supporting documents, and the amount of damages claimed.
- What supporting documents should I include?
- The instructions ask for available evidence supporting the claim, such as medical records or bills, photographs, proof of property ownership, receipts for property value, and other relevant documents.