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CLAIM AGAINST THE CITY OF SAN DIEGO

RM-9 (rev. 4-2017) This form is available in alternative formats upon request. PW/PS-258 Page 1 of 2 CLAIM AGAINST THE city OF SAN DIEGO Present CLAIM by personal delivery or mail to the city of San DIEGO , RiskManagement Department, 1200 Third Avenue, Suite 1000, San DIEGO , CA 92101 or via email to Including the claimant's email address on the returned CLAIM form is highly recommended. Claims for death, injury toperson or personal property must be filed no later than six (6) months after the occurrence (Gov. Code Section ). All other claims must be filed within one (1) year of theoccurrence. * = Required (Gov. Code Section 910)Received Via Email US Mail Over the Counter Inter-Office MailA. Claimant Name* (First, Middle, Last) Claimant Date of Birth Mo Day Year Claimant Address* Claimant Phone Number ( ) city * State* Zip* Claimant Social Security Number B.

CLAIM AGAINST THE CITY OF SAN DIEGO Present claim by personal mail delivery to the City or of San Risk Diego, Management Department, 1200 Third Avenue, Suite 1000, San CA 92101Diego, or via email to RiskManagement@sandiego.gov. Including the claimant's email address on the returned claim form is highly recommended. Claims for death, injury to

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