For All Persons or Property

1. Pursuant to the Public Records Act, a submitted claim is subject to public
disclosure and may be released to the media.

2. Claims for death, injury to person or to personal property, must be filed not later
than six months after the occurrence (Government Code Section 911.2)

3. Claims for damages to real property must be filed not later than one year after
the occurrence (Government Code Section 911.2)

4. Read the entire claim form before filing. Attach separate sheets, if necessary, to
give full details. Please PRINT OR TYPE your information.

5. Questions? Call the Antelope Valley Transit Authority at (661) 945-9445.

6. Return all completed claim forms to: Martin Tompkins, Executive Director/CEO,
Antelope Valley Transit Authority, 42210 6th Street West, Lancaster, CA
93534

Liability Claim Form