Liability Claim Form - City of Atascadero - atascadero 2025

1. Click ‘Get Form’ to open the Liability Claim Form in the editor.
2. Begin by entering your full name in the designated field. This is essential for identifying the claimant.
3. Fill in your address, including street, city, state, and zip code. If you have an alternate address, such as a P.O. Box, include that as well.
4. Provide your home and work phone numbers along with your date of birth for verification purposes.
5. If you are filing on behalf of a minor, include the parent or guardian's name.
6. Complete the sections regarding the date, time, and exact location of the incident. Be specific about what occurred.
7. Detail any injuries or damages incurred. If there were no injuries, clearly state that.
8. List any public employees involved and describe their actions that led to the claim.
9. Include witness information if available, providing names, addresses, and phone numbers.
10. Finally, specify the amount claimed and attach any relevant bills or estimates before signing the form.

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