Get 2062 Damage Claim Form. Claims Against The Department

Filling out the 2062 Damage Claim Form is an essential step for users seeking compensation for damages against the department. This guide provides clear instructions to ensure the process is straightforward and efficient, allowing users to complete the form accurately and submit their claim online.

Follow the steps to complete your damage claim form effectively.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. In the Claimant(s) section, provide the full name of the person or organization filing the claim.
3. If applicable, enter the Federal Employer Identification Number (FEIN) in the designated field.
4. If you are representing a company or organization, include the contact person's name.
5. Fill in the email address for communication purposes.
6. Provide your complete address, including street, apartment number, or P.O. box.
7. Enter the city, state, and zip code.
8. Input the home phone number, work phone number, and cell phone number as required.
9. In the Damaged Vehicle section, fill out details about the vehicle involved in the incident.
10. Provide the date and time of the incident, noting whether it occurred in the AM or PM.
11. List the model and tag number of the vehicle, along with the state of issuance.
12. Record the insurance company information if applicable, including policy numbers and contact phone numbers.
13. Indicate the amount being claimed for personal injury and for property damage, if relevant.
14. Describe the place of the incident, including specific routes or roads, and nearby intersections.
15. Address the county where the incident occurred.
16. Indicate whether the incident was reported to a law enforcement agency and provide details.
17. Write a detailed description of the incident, including its cause, the type of damage or injury sustained, and all parties involved.
18. List any witnesses to the incident, providing their names, addresses, and phone numbers.
19. Complete the Affidavit section by having the claimant appear before a notary public for signature.
20. Once all fields are completed, you can save changes, download, print, or share the form as necessary.

Begin your online claim process by filling out the 2062 Damage Claim Form today.