Get Wa Des Sf 210 2021-2025

The WA DES Sf 210 form, also known as the standard tort claim form, is essential for filing a claim against the state of Washington. This guide provides clear, step-by-step instructions to assist users in completing the form accurately and efficiently.

Follow the steps to complete the WA DES Sf 210 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In section 1, enter the claimant's name, including last name, first name, middle name, and date of birth in the format mm/dd/yyyy.
3. If applicable, fill in the inmate DOC number in section 2.
4. Complete section 3 with the current residential address and section 4 with the mailing address if it differs.
5. In section 5, note the residential address at the time of the incident, if different from the current address.
6. Provide the claimant's daytime telephone number in section 6, specifying if it is home or business/cell.
7. Enter the claimant’s email address in section 7.
8. Specify the date of the incident in section 8, using mm/dd/yyyy format, including the time of occurrence in a.m. or p.m.
9. If the incident occurred over time, indicate the date range and corresponding times in section 9.
10. Describe the location of the incident in section 10, including state, county, and city if applicable.
11. If the incident occurred on a street or highway, fill out the details in section 11, including street name, milepost number, and nearest intersection.
12. Identify the state agency or department responsible in section 12.
13. In section 13, list all individuals involved in or witnesses to the incident, including their contact information.
14. Provide the names, addresses, and contact numbers of state employees who have knowledge about the incident in section 14.
15. In section 15, detail any additional individuals who may have knowledge regarding liability issues or the claimant’s damages.
16. Describe the cause of the injury or damages in section 16, explaining the extent of losses and attaching additional sheets if necessary.
17. Indicate if the incident was reported to law enforcement in section 17 and provide attached documents if applicable.
18. List names and contact details of treating medical providers in section 18, and attach medical reports.
19. Attach all supporting documents that corroborate the claim as instructed in section 19.
20. In the final section, claim the amount of damages sought from the state, sign the form and provide the necessary signature and date below.
21. Upon completion, review all entered information for accuracy. Save changes, download a copy, print, or share the completed form as needed.

Complete your WA DES Sf 210 form online today to ensure your claim is filed correctly and efficiently.