Superior Court Claim Form PDF Details

Navigating the intricacies of the legal system can often feel like an insurmountable task, especially when it involves presenting a case against a governmental entity within the judicial branch. At the heart of this seemingly daunting process lies the Superior Court Claim form, a critical document that serves as the first step for individuals seeking to assert their rights and obtain redress for grievances. Governed by Government Code section 910.4, this standardized form is meticulously designed to collect all the necessary information that the court or the relevant official requires to assess the claim. It demands specifics such as the claimant's personal information, detailed accounts of the incident at hand including the date, time, and location, as well as a thorough description of the damages or injuries suffered as a result. Crucially, it distinguishes between claims of up to $10,000 and those that exceed this amount, guiding the claimant towards identifying their claim as either a limited civil case or an unlimited civil case, with the latter involving more substantial sums. Furthermore, the form insists on a precise calculation of the claim amount, supported by relevant evidence, and even allows for the inclusion of witness information and any additional context that might aid in the claim's evaluation. It also opens a path for representation, allowing claimants the option to have the claim presented by an authorized representative, thus underscoring the legal system's flexibility in accommodating the needs of those it serves. However, it's imperative to note the stern warning against the presentation of false claims, a safeguard aimed at preserving the integrity of the judicial process. With such comprehensive requirements, the Superior Court Claim form stands as a testament to the legal framework's commitment to thorough examination and fairness, ensuring that every claim is given the attention and scrutiny it rightly deserves.

QuestionAnswer
Form NameSuperior Court Claim Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namessuperior court of fresnof forms, claim branch, claim superior court, superior court of california orange county sample of complaint's claim of damages

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GOVERNMENT CLAIM—JUDICIAL BRANCH

(Government Code section 910.4)

FOR COURT OR OFFICIAL USE ONLY FOR COURT OR OFFICIAL USE ONLY

[DATE STAMP]

Postmark date if received by mail: _________

Postmark date if received by mail: ___________

CLAIMANT

Name of Claimant

 

Home Telephone

Work Telephone

 

 

 

 

Mailing Address

City

State

Zip Code

 

 

 

Send notices regarding this claim to (IF DIFFERENT FROM ABOVE):

 

 

Name

 

 

 

 

 

 

 

Mailing Address

City

State

Zip Code

 

 

 

 

 

 

CLAIM INFORMATION

 

Date of Incident (Month/Day/Year)

Time of Incident

 

 

 

 

 

Location of Incident

 

 

Describe the indebtedness, obligation, injury, damage, or loss incurred as a result of the incident.

State the circumstances that gave rise to this claim. (State the facts that support your claim and why you believe the court or another judicial branch entity is responsible for the alleged damage or injury.) If known, provide the name of the official or employee who allegedly caused the injury, damage, or loss (if there is more than one official or employee, name each). If you need more space, please attach additional sheets of paper.

GOVERNMENT CLAIM—JUDICIAL BRANCH

PAGE 1 of 2

Name of Claimant: ____________________________

If the total amount of your claim is up to $10,000:

Amount of damages as of this date: Estimated amount of future damages: Total amount claimed:

If the amount of your claim is more than $10,000, indicate whether your claim would be a limited civil case or an unlimited civil case (CHECK ONE):

Limited civil (amount is $25,000 or less) Unlimited civil (amount is more than $25,000)

State how the amount of your claim was computed (include copies of supporting documentation such as billing statements, invoices, receipts, and estimates).

List the names, addresses, and telephone numbers of all witnesses to the incident.

Provide any additional information that might be helpful in considering this claim.

REPRESENTATIVE (Complete only if claim is presented by someone acting on claimant’s behalf)

Name of Authorized Representative

 

Telephone

 

 

 

Mailing Address

City

State Zip Code

 

 

 

PLEASE NOTE: PRESENTATION OF A FALSE CLAIM WITH INTENT TO DEFRAUD IS A CRIMINAL OFFENSE (PENAL CODE SECTION 72).

 

 

 

 

Signature of □ Claimant or □ Authorized Representative (CHECK ONE)

Date

DELIVER OR MAIL THIS CLAIM FORM TO:

 

 

Attention: Court Executive Officer (Claims)

 

 

Superior Court of California, County of Los Angeles

 

 

Stanley Mosk Courthouse

 

 

111 North Hill Street, Room 105E

 

 

Los Angeles, CA 90012

 

 

GOVERNMENT CLAIM—JUDICIAL BRANCH

PAGE 2 OF 2

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This PDF form will need you to provide specific details; to ensure accuracy, you should adhere to the tips further on:

1. You'll want to complete the orange county superior court departments claim correctly, thus take care when filling in the segments comprising these particular fields:

Writing segment 1 of la superior court small claims

2. Once the previous section is done, you need to add the required specifics in Date of Incident MonthDayYear, GOVERNMENT CLAIMJUDICIAL BRANCH, and PAGE of so you're able to proceed to the third part.

Writing segment 2 in la superior court small claims

Those who use this form frequently make mistakes when completing GOVERNMENT CLAIMJUDICIAL BRANCH in this area. You need to revise what you enter right here.

3. The following segment is all about If the total amount of your claim, Name of Claimant, If the amount of your claim is, and State how the amount of your claim - fill in each one of these fields.

Stage number 3 of completing la superior court small claims

4. To go forward, this next stage requires typing in a handful of blanks. These include State how the amount of your claim, REPRESENTATIVE Complete only if, Name of Authorized Representative, City, State Zip Code, Telephone, Signature of Claimant or, and Deliver or mail this claim form to, which you'll find crucial to carrying on with this particular form.

Filling out part 4 in la superior court small claims

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