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Caltrans pothole claim form

Ld 0274 form 2004-2025

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The document is a claim form for individuals seeking to file a claim against the California Department of Transportation for amounts of $5,000 or less. It outlines the necessary personal information, incident details, and required documentation for processing the claim. The form emphasizes the voluntary nature of providing personal information and includes instructions for submission, as well as contact information for claims exceeding $5,000.

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Click ‘Get Form’ to open the ld 0274 form 2004 in the editor.
Begin by entering your personal information in the designated fields, including your name, home address, and contact numbers. Ensure accuracy as this information is crucial for processing your claim.
Specify the time and date of the incident. This helps establish a timeline for your claim. Be precise to avoid any delays.
Describe the location of the incident clearly, providing details such as city, county, and any relevant landmarks. This information is vital for investigation purposes.
In the explanation section, detail how the damage or loss occurred. Clearly state what actions or omissions by Caltrans or its contractors led to your loss.
Indicate the dollar amount of your loss and attach any supporting documents like receipts or estimates to substantiate your claim.
Complete the insurance information section accurately. Indicate whether you are the registered owner and if you have submitted a claim to your insurance carrier.
Finally, certify that all provided information is true by signing and dating the form before submission.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (20 Votes)
2010	4.9 Satisfied (366 Votes)
2004	4.3 Satisfied (40 Votes)
2003	3.9 Satisfied (26 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How much does California reimburse for pothole damage?

The state of California might reimburse you up to $10,000 in vehicle damages caused by potholes if you file within six months of the incident and successfully prove that CalTrans or its contractor knew or should have known about the pothole at the time of damage.

Can I get reimbursed for pothole damage in California?

California Department of Transportation (Caltrans) If you drove over a pothole on the freeway, highway or other state roadway, contact Caltrans at dot.ca.gov. Theres a Submit Damage Claim link on the far right column with more information.

Can you sue the city for pothole damage in California?

If youve been injured or suffered financial losses due to a pothole accident in California, you may have a case against the city, county, or state agency responsible for the road. However, strict legal deadlines apply, and filing a claim quickly is critical.

Will Los Angeles reimburse for pothole damage?

Claim Forms Cities are responsible for potholes on the streets within their boundaries but not on highways. Claims can be filed with the city of Los Angeles here. Counties repair streets in unincorporated areas and some smaller cities. Los Angeles County provides a claim form here.

Can you file a claim for a flat tire?

Does insurance cover flat tires? In short, no. For example, if you get a flat tire because you run over a sharp object or drive on worn tires, your auto policy wont cover repairs. Additional options like roadside assistance can provide help if you experience unexpected tire-related issues on the road.

caltrans damage claim form pdf

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How to get insurance to pay for pothole damage?

Hitting a pothole with your car may be considered a single-vehicle accident. So, you may be able to make an insurance claim for pothole damage with your insurance company if you have collision coverage.

Ld 0274 form 2004-2025

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Got questions?

How much does California reimburse for pothole damage?

Can I get reimbursed for pothole damage in California?

Can you sue the city for pothole damage in California?

Will Los Angeles reimburse for pothole damage?

Can you file a claim for a flat tire?

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How to get insurance to pay for pothole damage?

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