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Get CA Superior Court Government Claim

Signature of Claimant or Authorized Representative check one Deliver or mail this claim form to Attention Court Executive Officer Claims Superior Court of California County of Los Angeles Stanley Mosk Courthouse 111 North Hill Street Room 105E Los Angeles CA 90012 PAGE 2 OF 2 Date. FOR COURT OR OFFICIAL USE ONLY DATE STAMP Postmark date if received byby mail GOVERNMENT CLAIM JUDICIAL BRANCH Government Code section 910. 4 CLAIMANT Name of Claimant Home Telephone Mailing Address City Work Telephon.

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