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2. The City of Watauga is part of the Texas Municipal League Intergovermental Risk Pool (TMLIRP). When an incident occurs involving City property or at any City facility the City Secretary's Office must act quickly to ensure all necessary documentation is gathered, processed and filed in an efficient and prompt manner. Please submit this form to the City Secretary's Office, within 48 hours of the occurrence. Please include any reports, incident reports, pictures, or statements which may assist the City Secretary's Office in processing the claim.
   
   THIS FORM IS NOT FOR REPORTING AN INCIDENT TO HUMAN RESOURCES REGARDING A VEHICLE ACCIDENT INVOLVING AN EMPLOYEE. VEHICLE ACCIDENTS INVOLVING EMPLOYEES MUST BE PROCESSED THROUGH HUMAN RESOURCES.
4. 
   

   THIS IS NOT FOR FILING POLICE REPORTS PLEASE CONTACT OUR POLICE DEPARTMENT AT 817-514-5897.

6. Date of Occurrence?*
8. Was there city property damaged?*
   -- Select One --YesNo
10. What was damaged?*
12. Is the damage estimated to be over $2,500?*

    1. Yes
    2. No
    3. Not Sure?
14. Were there any non-employee injuries?

    1. Yes
    2. No
16. Please describe the number of individuals injured and type of injuries.*
18. Please upload any pertinent accident/incident reports, pictures or statements.
20. Upload 1:
22. Upload 2:
24. Upload 3:
26. Upload 4:
28. Upload 5:
30. Upload 6:
32. Upload 7:
34. Upload 8:
36. Upload 9:
38. Upload 10:
40. 
    
42. Name and Title of who is submitting claim report:*
44. Office Phone Extension:*
46. Your Email Address:*
48. 
    
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit Submit and Print

* indicates a required field