Get Ca Vcgcb-gc-002 2014

The CA VCGCB-GC-002 form is essential for filing a claim with the California Victim Compensation and Government Claims Board. This guide provides a clear, step-by-step approach to help users complete the form efficiently and accurately.

Follow the steps to successfully fill out your claim form.

1. Press the ‘Get Form’ button to access the CA VCGCB-GC-002 online and open it in your preferred editor.
2. Fill in the full name of the person claiming damage or injury. If the claimant is an entity, enter the entity's name.
3. Provide a daytime telephone number where you can be reached.
4. If you choose, enter an email address for communication regarding your claim.
5. Complete the mailing address section with your current address.
6. If applicable, include your identification number (for inmates or patients at a state hospital).
7. If you are filing on behalf of a minor, please provide their birth date.
8. For insurance companies claiming subrogation, enter your insured’s name here.
9. If your claim is related to another claimant, please provide the relevant claim number or name.
10. If representing the claimant, provide your details in the attorney or representative information section.
11. Enter the daytime phone number for the representative along with their email address (optional).
12. Provide a complete mailing address for the representative.
13. Describe the representative's relationship to the claimant.
14. If your claim is for a stale-dated warrant, complete the relevant section and attach a copy of the front and back of the warrant.
15. State the exact date of the incident, or provide the date range if applicable.
16. Indicate if the incident was over six months ago and if you have attached an explanation for late filing.
17. Specify the state agency involved and provide its full name, including any employees involved.
18. Enter the total dollar amount being claimed and explain how you calculated this amount.
19. Provide the location of the incident, ensuring you include street address, city, and any relevant landmarks.
20. Describe the specific damage or injury experienced as a result of the incident.
21. Explain the circumstances surrounding the incident, detailing the facts supporting your claim.
22. Clarify why you believe the state agency is responsible for the damage or injury.
23. If the claim involves a state vehicle, include the vehicle's license number and other identifying information.
24. Complete the insurance information section, providing details about any claims filed with your insurance carrier.
25. Make sure to attach the $25 filing fee, payable to the State of California, or include a ‘Filing Fee Waiver Request’ if applicable.
26. Sign and date the form, providing your printed name above the signature.
27. Finally, mail the completed form and all attachments, along with the $25 filing fee or waiver request, to the specified address.

Begin your online claim process today and ensure that all necessary documents are completed accurately.