Tort Claim Form

Instructions for Turning in a formcompleting a standard tort claim form

  1. Complete the Standard Tort Claim Form by downloading the form below. The form is also maintained at the Risk Management Office of the Lake Washington School District No. 414.
    Agent to receive claim: Dale Cote
    Office Location: 16250 N.E. 74th St.
    Redmond, WA 98052
    Mailing Address: P.O. Box 97039
    Redmond, WA 98073
    Business Hours: Monday – Friday: 7:30 a.m. – 4:30 p.m.
    Closed on weekends and official school holidays
  2. Tort Claim Form must be typed or printed clearly in ink.
  3. Provide all requested information and any available documents supporting your claim.
  4. If the requested information cannot be supplied in the space provided, please use additional blank sheets so your claim can be easily read and understood.
  5. Sign by an authorized party.
  6. Present properly completed and signed Tort Claim Form in one of the following manners:
    • Personal delivery to the registered agent or authorized person in the office of the registered agent during above business hours.
    • Deliver by registered mail to the registered agent.
    • Deliver by certified mail (with return receipt) to the registered agent.

Download a Tort Claim Form