File a Claim for Damages

If you believe that the City is liable for damages to you or your property, you must complete a Claim for Damages Form within three years from the time of the incident, or if a minor at the time of incident, before you reach the age of 21. Due to City Hall closure, staff are not currently available for notarizations. 

Online

Step 1.Download a Claim for Damages form

Step 2.Fill out completely

  • Type or print legibly.
  • Submit any available documents or evidence supporting your claim.
  • If the requested information cannot be supplied in the space provided on the form, use additional blank sheets or word documents.

Step 3.Notarize

  • Must be notarized before submitting.
    • Due to City Hall Closure, staff are not currently available for notarizations. Please use other means before submittal (e.g., banks, postal services, local businesses, etc.)

Step 4.Submit to City Clerk's Office via City Hall drop box

  • City Hall has a drop box outside the North Entrance for form submittals.
  • Electronic or faxed copies will not be accepted.

Step 5.Process of the claim 

  • The claim will be sent to the city's Human Resources Coordinator.
  • The claim is then sent to WCIA for investigation to determine the City's responsibility.
  • WCIA will contact you with next steps.

Phone/Email

Step 1.Obtain a Claim for Damages form

  • Call the City Clerk's Office or Human Resources Division to receive one by email. If leaving a voicemail please include a valid email or phone number to reach you.

Step 2.Fill out completely

  • Type or print legibly.
  • Submit any available documents or evidence supporting your claim.
  • If the requested information cannot be supplied in the space provided on the form, use additional blank sheets or word documents.

Step 3.Notarize

  • Must be notarized before submitting.
    • Due to City Hall closure, staff are not currently available for notarizations. Please use other means before submittal (e.g., banks, postal services, local businesses, etc.)

Step 4.Submit to City Clerk's Office via City Hall drop box

  • City Hall has a drop box outside the North Entrance for form submittals.
  • Electronic or faxed copies will not be accepted.

Step 5.Process of the claim 

  • The claim will be sent to the city's Human Resources Coordinator.
  • The claim is then sent to WCIA for investigation to determine the City's responsibility.
  • WCIA will contact you with next steps.

In Person

Obtain a Claim for Damages form from the Customer Service Desk at City Hall

Currently all City facilities are closed to the public in alignment with Governor Inslee's Safe Start Washington plan for reopening. Please use other means to obtain a Claim for Damages form.

Contact Us

Phone

425-587-3190

Alternate Phone

425-587-3214

Email

CCO@kirklandwa.gov

Location

City Hall
123 5th Ave
98033
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