Please enter a phone number for any of the following that apply
* Please confirm the accuracy of these statements
, confirm that the following statements are true and correct to the best of my knowledge on this day of
* CLAIM FOR INJURY
In the next section describe in your own words where, when, and how the damage or injury occurred. Attach additional pages if necessary. Give names and addresses of others involved and/or witnesses, if known.
* Description of how damage or injury occurred
* Attach legible copies of all medical reports, medical bills and/or estimates of damages regarding this loss.
* File must be less than 20 MB (only PDFs or images). Please click the SELECT button to add your document(s)
If known, the TOTAL amount of your claim against the CITY OF MCALLEN is, AND
the POLICE CASE NUMBER (if known):
NOTE: After your claim is received, it will be processed for service/handling.
Should you have any questions regarding your claim, please contact:
Risk Management Department
City of McAllen
P.O. Box 220, 78505
McAllen, Texas 78501
(956) 681-1425