Risk Management

SUBMIT A CLAIM

-- TYPE OF CLAIM

SELECT A CLAIM TYPE BELOW:

Property DamagePersonal Injury

INCLUDE A POLICE CASE NUMBER, IF KNOWN:

IF KNOWN, THE TOTAL AMOUNT OF YOUR CLAIM AGAINST THE CITY OF McALLEN IS:

-- CLAIMANT ACKNOWLEDGEMENT

BY CHECKING THIS BOX

, I ACKNOWLEDGE

THAT I AM NOT UNDER THE EMPLOYMENT OF THE CITY OF MCALLEN AT THE TIME OF OCCURRENCE.

-- CLAIMANT INFORMATION

Title:

First Name:

M.I. :

Last Name:

Address:

City:

State:

Zip Code:

Email Address

Home Number

Cell Number

Other Number

-- CLAIM FOR INJURY / PROPERTY DAMAGE

Date of Ocurrence:

Time:

In the next section describe in your own words where, when, and how the damage or injury occurred. Give names and addresses of others involved and/or witnesses, if known.

Description Here

NOTE: If any additional documents (i.e., reports, invoices, photos) are in your possession, you may fax, mail or email the information to:

City of McAllen
ATTN: Risk Management
P.O. Box 220, 78505-220
McAllen, Texas 78501
(956) 681-1410

* Please Confirm the Accuracy of these Statements

BY CHECKING THIS BOX ,

I CONFIRM

that the statements above are true and correct to the best of my knowledge on this day of

Date:

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Risk Management

SUBMIT A CLAIM

-- TYPE OF CLAIM

SELECT A CLAIM TYPE BELOW:

-- CLAIMANT ACKNOWLEDGEMENT

-- CLAIMANT INFORMATION

-- CLAIM FOR INJURY / PROPERTY DAMAGE

In the next section describe in your own words where, when, and how the damage or injury occurred. Give names and addresses of others involved and/or witnesses, if known.

NOTE: If any additional documents (i.e., reports, invoices, photos) are in your possession, you may fax, mail or email the information to:

City of McAllen
ATTN: Risk Management
P.O. Box 220, 78505-220
McAllen, Texas 78501
(956) 681-1410

* Please Confirm the Accuracy of these Statements

* Captcha

Contact Info

Yolanda Perez,
Director of Risk Management

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City Hall

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Download the 311 App

Risk Management

SUBMIT A CLAIM

-- TYPE OF CLAIM

SELECT A CLAIM TYPE BELOW:

-- CLAIMANT ACKNOWLEDGEMENT

-- CLAIMANT INFORMATION

-- CLAIM FOR INJURY / PROPERTY DAMAGE

In the next section describe in your own words where, when, and how the damage or injury occurred. Give names and addresses of others involved and/or witnesses, if known.

NOTE: If any additional documents (i.e., reports, invoices, photos) are in your possession, you may fax, mail or email the information to:

City of McAllen ATTN: Risk Management P.O. Box 220, 78505-220 McAllen, Texas 78501 (956) 681-1410

* Please Confirm the Accuracy of these Statements

* Captcha

Contact Info

Yolanda Perez, Director of Risk Management

City of McAllen
ATTN: Risk Management
P.O. Box 220, 78505-220
McAllen, Texas 78501
(956) 681-1410

Yolanda Perez,
Director of Risk Management