Government Claim Form

Using Government Claim Form

The information included in, and omitted from, a government claim form can have serious legal consequences. For instructions on how to most effectively fill out a government claim form, you should consult with a qualified attorney.

Pursuant to the California Government Code, beginning at Section 900, any individual seeking to file a claim for money or damages against the judicial branch must first file a written government claim.

While there is no established form for filing a government claim, Gov. Code Section 910 does list the items of information that must be included in the claim form. For convenience purposes, a form for filing a government claim can be found at the following link:

Government Claim - Judicial Branch

Once you have completed and signed the form, you can personally return it to the Court by handing it to a clerk in the Jury Services Office at the Gibson Courthouse in Roseville or at any clerk’s office window at any Placer Superior Court facility. If you would prefer, you can also mail the original signed claim form to the following address:

Attention: Court Executive Officer (Claims)
Superior Court of California, County of Placer
P.O. Box 619072
Roseville, CA 95661-9072