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The form requests identification and contact information, insurance policyholder and insurance claim history, incident date/time and location, witness information, and a narrative describing how damage occurred. It also requires police report and departmental report numbers, supporting written estimates or paid bills with proof, additional submitted materials, and formal awareness and certification sections with signature and date.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/city-of-chicago-property-damage-claim-form/277134/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/city-of-chicago-property-damage-claim-form/277134.png","ImageObject",442,249,{"name":88,"@type":89},"Xiajie","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-30","2026-09-15",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",22,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What information must be provided on the City of Chicago property damage claim form?","Question",{"text":109,"@type":110},"The form requires claimant details, insurance information, incident date/time and location, witness information (if applicable), a description of how the damage occurred, and relevant report numbers.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"Are written estimates or paid bills required for all claims?",{"text":114,"@type":110},"The form includes a section indicating that two written itemized estimates or an itemized paid bill with proof of payment must be attached.",{"name":116,"@type":107,"acceptedAnswer":117},"Where should the completed claim form be mailed?",{"text":118,"@type":110},"Mail the form to City of Chicago Claims Unit, 2 N. 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A. M./P. M. |\n|  |  | MM DD YYYY |\n| 11. | Incident Location:(provide specific address, i.e. 1234 W. Main St.): |  |\n| 12. | Witness Name (if applicable): | First Middle Initial Last Name |\n| 13. | Witness Address: |  |\n\n(OVER)  \n\n| 14. | Witness City, State & Zip Code: |  |\n| --- | --- | --- |\n| 15. | Witness Telephone: | Office Home Cellular |\n| 16. | Description of Incident (give details of how damage occurred) * Use additional sheet if necessary: |  |\n| 17. | Police Report Number: |  |\n| 18. | City Department Report: |  |\n| 19. | Two Written Itemized Estimates attached on company letterhead or Itemized Paid Bill with proof of payment attached: | Two Written Estimates Itemized Paid Bill |\n|  |  |  |\n| 20. | Additional information submitted\u003Cbr>([i.e. photos](i.e. photos), etc.): |  |\n| 21. | I am aware of the substantial penalties, attorneys', and legal fees that may be imposed for filing a false or fraudulent claim, pursuant to Municipal Code, Ch. 1, Sec. 1-22-020: |  |\n|  |  | Signature Date |\n| 22. | Certification-This signature certifies that the information on this form is true and accurate to the best of my knowledge. I have submitted this information in a manner that represents the true facts of this claim for the purpose of investigating this claim . |  |\n|  |  | Signature Date |\n\nREMEMBER  \n--Respond to all questions  \nAttach supporting evidence and information  \nMail this form to:  \nCity of Chicago Claims Unit 2 N. La Salle St., Suite 350 Chicago, IL 60602 312.744.5650 Voice  \n312.744.5449 Fax [cityofchicagoclaims@ccmsi.com](cityofchicagoclaims@ccmsi.com)","cbCaiqIsPchF8aF4","https://ap.wps.com/l/cbCaiqIsPchF8aF4","pdf",98000,"English","# Required Information\n# Claimant and Insurance Details\n# Incident Information\n# Witness Information\n# Damage Description and Reports\n# Supporting Evidence and Certification\n# Submission Instructions","[{\"question\":\"What information must be provided on the City of Chicago property damage claim form?\",\"answer\":\"The form requires claimant details, insurance information, incident date/time and location, witness information (if applicable), a description of how the damage occurred, and relevant report numbers.\"},{\"question\":\"Are written estimates or paid bills required for all claims?\",\"answer\":\"The form includes a section indicating that two written itemized estimates or an itemized paid bill with proof of payment must be attached.\"},{\"question\":\"Where should the completed claim form be mailed?\",\"answer\":\"Mail the form to City of Chicago Claims Unit, 2 N. La Salle St., Suite 350, Chicago, IL 60602, with the contact phone and fax details provided on the form.\"}]","City of Chicago - Property Damage Claim Form | PDF"]