HomeMy WebLinkAboutMelanie Sanders - 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:
Melanie Sanders
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:*
05/19/24 05:00:00 PM
Location of Incident:*
Garage
DESCRIBE IN DETAIL WHAT DAMAGE OR INJURY OCCURRED:
With all the construction going on on Hankins Road,Elizabeth,and the apartment water line hook up on Kimberly Road and Hankins,you
could hear our water heater like expanding and making weird noises,not sure how else to explain it. After talking with our backyard
neighbor Carla Colfack,we both found it odd we had the same thing happening and had to replace our water heaters within 6 months of
each other. As with her,the plumber would not say if that is what caused the malfunction with our water heater. Carla also submitted a
tort claim to the City Nov 19th. I look forward to hearing from the City regarding this matter. Thank you,Melanie
Additional Files/Pictures:
Cost of Property Damage or Bodily Injury:
$1,700.00
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*
11/23/2024
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.