Claim Form - City of Pomona - ci pomona ca 2026

1. Click ‘Get Form’ to open the Claim Form in the editor.
2. Begin by entering your personal information, including your name, date of birth, and contact details. Ensure accuracy as this information is crucial for communication regarding your claim.
3. In the section detailing the incident, specify when and where the damage or injury occurred. Use clear descriptions and refer to the diagram provided on page 2 for precise location marking.
4. Describe how the damage or injury happened in detail. This is essential for establishing responsibility.
5. List all damages incurred, including medical expenses and loss of earnings. Be thorough to ensure all potential claims are documented.
6. If applicable, provide information about any witnesses or medical professionals involved. This can support your claim significantly.
7. Finally, sign the form on page 2 and attach any additional sheets if necessary. Make sure each sheet is signed.

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