HomeMy WebLinkAboutAngie Whitecotton - Tort Claim Claim for Property Damage or Bodily Injury
NOTE:This form is being provided as a courtesy to assist you in filing your claim.Providing this form to you is not an admission,nor shall it be
construed to be an admission,of liability or an acknowledgement of the validity of a claim by the political subdivision.Legal requirements for
filing claims can be found in Idaho Code:Title 6.Chapter 9.All claims must be filed promptly.
CLAIMANT INFORMATION:
......... ......... ......... ......... ......... ......... ......... ......... ......... ........
First Name:* Last Name:
Angie Whitecotton
Physical Address
Street*
City* State* ZIP Code*
Twin Falls Idaho 83301
Have you lived at this address for at least 6 months prior to the incident date?
Yes No
My mailing address is different than my physical address
Phone Number* Email Address:
xxx-xxx-xxxx
INCIDENT INFORMATION:
. .................................................................................................................................................................................................................................................................................................................................................................................................................................
Date of Incident:*
11/24/24 07:00:00 PM
Location of Incident:*
459 Aspenwood Dr
DESCRIBE IN DETAIL WHAT DAMAGE OR INJURY OCCURRED:
The bottom of our water heater blew out;it was only 7 years old.I talked to a few neighbors in the area who have had the same issues with
newer water heaters,who stated that it could be due to all the construction and pressure issues we had in the area.I know of two who have
also put cases that live on Denise Ave.and Leeann Dr.
We had ZERO issues with the water heater until it blew out the bottom,which is odd for a 7-year-old water heater.That is seen more in 20+
old heaters.
Additional Files/Pictures:
You may attach any other information or documentation you desire.
Cost of Property Damage or Bodily Injury:
$2,084.92
Property Damage or Bodily Injury:*
Property Damage
Bodily Injury
Property Damage and Bodily Injury
I hereby make a claim against the City of Twin Falls and I hereby certify that I have read the above information and it is true and correct to the
best of my knowledge.
Date* Signature*
12/2/2024
amp;, Wht)-ereffea
Per Idaho Statute Title 41,Chapter 13:41-1331 -Any person who knowingly,and with intent to defraud or deceive any insurance company,files a
statement of claim containing any false,incomplete,or misleading information is guilty of a felony."Statement"includes,but is not limited to,
any notice,statement,proof of loss,bill of lading,receipt for payment,invoice,account,estimate of property damages,bills for services,
diagnosis,prescription,hospital or doctor records,x-ray test results,or other evidence of loss,injury,or expense.