California
Statewide
Victim Compensation And Government Claims Board
Government Claims Program
Last updated: 12/31/2019
Government Claims Form {DGS ORIM 06}
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Description
DGS ORIM 006, GOVERNMENT CLAIM, • Include a check or money order for $25, payable to the State of California. • $25 filing fee is not required for amendments to existing claims. • Confirm all sections relating to this claim are complete and the form is signed. • Attach copies of any documentation that supports your claim. Do not submit originals. www.FormsWorkflow.com
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