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Delano Joint HSD  |  E  3320  Business and Noninstructional Operations

Claims And Actions Against The District   

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CLAIM FOR DAMAGES TO PERSON OR PROPERTY

INSTRUCTIONS:

1. Claims for death, injury to person or personal property must be filed not later than six months after the occurrence. (Government Code 911.2)

2. Claims for damage to all other property must be filed not lather than one year after the occurrence.

3. Attach separate sheets, if necessary, and sign each sheet.

4. Claim must be filed with the School District (Government Code 915a)

To: (Name of School District)

Name of Claimant and age, including name of parent/guardian if required:

Address of Claimant:

Telephone Number:

Address where notices are to be sent:

When did injury or damage occur? Give full particular, date and time of day:

Where did injury or damage occur? Describe fully and provide diagram where appropriate, give street name and address and measurements from landmarks. (Use second page if necessary):

How did injury or damage occur? Give full particulars (Use second page if necessary):

What particular act or omission do you claim caused the injury or damage? Give names of school district employees causing injury or damage, if known:

What damage or injury do you claim resulted? Give full extent of injury or damage claimed:

What amount do you claim on account of each item of injury or damage as of the date of presentation of this claim, including prospective injury, damages or loss, and give basis of computation of amount (Use second page if necessary):

Name and address of witnesses, doctors and hospitals:

State amount claimed as damages, please attach any supporting bills, receipts, or estimates of cost (Please indicate):

Less than $10,000.00 $ (State specific amount)

$10,000.00 - $25,000.00 (Limited Civil)

More than $25,000.00 (Unlimited Civil)

Additional information that might be helpful in considering this claim:

Signature of Clamant or person filing on his behalf, giving relationship to claimant:

Signature Type name Date

NOTE: Claims must be filed with the School District (Government Code 915a). Presentation of a false claim is a felony (Penal Code 72).

Exhibit DELANO JOINT UNION HIGH SCHOOL DISTRICT

version: June 10, 2003 Delano, California

E(2) 3320

CLAIMS AND ACTIONS AGAINST THE DISTRICT

NOTICE OF INSUFFICIENCY

Government Code 910.8

TO: [Claimant]

[Address]

RE: Claim Filed [date]

The claim presented by you on [date] fails to comply substantially with the requirements of Government Code 910 and 910.2 or with the requirements of the district's claim form provided under Government Code 910.4. Specifically, your claim is insufficient because of the following defects or omissions:

Therefore, the claim is being returned to you without further action or consideration. If you wish to pursue this further, you should consult the Government Code or legal counsel.

The Governing Board will not take any action on the claim for a period of 15 days from the date of this notice.

Dated:

Signature

Typed Title of Officer

Exhibit DELANO JOINT UNION HIGH SCHOOL DISTRICT

version: June 10, 2003 Delano, California

E(3) 3320

CLAIMS AND ACTIONS AGAINST THE DISTRICT

NOTICE OF FAILURE TO FILE IN A TIMELY MANNER

Government Code 911.3

TO: [Claimant]

[Address]

RE: Claim Filed [date]

The claim you presented to the Superintendent or designee on [date] is being returned because it was not presented within six months after the event or occurrence as required by law. See 901 and 911.2 of the Government Code. Because the claim was not presented within the time allowed by law, no action was taken on the claim.

Your only recourse at this time is to apply without delay to Delano Joint Union High School District for leave to present a late claim. See 911.4 to 912.2, inclusive, and 946.6 of the Government Code. Under some circumstances, leave to present a late claim will be granted. See 911.6 of the Government Code.

You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately.

Exhibit DELANO JOINT UNION HIGH SCHOOL DISTRICT

version: June 10, 2003 Delano, California

E(4) 3320

CLAIMS AND ACTIONS AGAINST THE DISTRICT

DENIAL OF APPLICATION TO FILE A LATE CLAIM

Government Code 911.8

TO: [Claimant]

[Address]

RE: Claim Filed [date]

Your application to file a late claim presented on [date] has been denied. The Governing Board has determined that your claim does not satisfy one of the four conditions listed in Government Code 911.6.

WARNING

If you wish to file a court action on this matter, you must first petition the appropriate court for an order relieving you from the provisions of Government Code 945.4 (claims presentation requirement). See Government Code 945.6. Such petition must be filed with the court within six months from the date your application for leave to present a late claim was denied.

You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately.

Exhibit DELANO JOINT UNION HIGH SCHOOL DISTRICT

version: June 10, 2003 Delano, California

E(5) 3320

CLAIMS AND ACTIONS AGAINST THE DISTRICT

NOTICE OF ACTION TAKEN ON CLAIM

Government Code 913

Dear :

Notice is hereby given that the claim you presented to the Delano Joint Union High School District on [date] was [rejected, allowed, allowed in the amount of $ and rejected to the balance, rejected by operation of law or other appropriate language, whichever is applicable] on [date of action or rejection by operation of law].

WARNING

Subject to certain exceptions, you have only six months from the date this letter was personally delivered or deposited in the mail to file a court action on this claim. See Government Code 945.6.

You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately.

Dated:

Signature

Typed Title of Officer

Exhibit DELANO JOINT UNION HIGH SCHOOL DISTRICT

version: June 10, 2003 Delano, California

E(6) 3320

CLAIMS AND ACTIONS AGAINST THE DISTRICT

NOTICE OF ACTION TAKEN ON CLAIM

Government Code Section 913

Dear :

Notice is hereby given that the claim you presented to the Delano Joint Union High School District on [date] was [rejected, allowed, allowed in the amount of $ and rejected to the balance, rejected by operation of law or other appropriate language, whichever is applicable] on [date of action or rejection by operation of law].

WARNING

Subject to certain exceptions, you have only six (6) months from the date this letter was personally delivered or deposited in the mail to file a court action on this claim. See Government Code Section 945.6.

You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately.

Dated:

Signature

Printed Name and Title of Officer

Exhibit DELANO JOINT UNION HIGH SCHOOL DISTRICT

version: June 16, 2009 Delano, California