- Check Amount
- Check Date
- Check Number
- Claimant or Authorized Agent Signature
- Daytime Phone Number
- Payee Full Name/Business Name
- Social Security Number/Taxpayor ID
- Street Address
Also if you are filing a claim for which there are multiple payees on the check, please note that each payee must sign the claim form and submit the required documentation. In addition, you signature will need to be notarized if your claim exceeds $500.
The following documentation must also be provided to our office when filing your claim:
- A copy of current photo identification for each claimant
- Verification of address, if mailing address is different from original mailing address or photo identification
- Death Certificate (if making claim for deceased original owner)
- Copy of current photo identification for the authorized agent signing the form
- Letter of Authorization on Company letterhead with the names of officers or officials with authority to sign and claim on behalf of the business.
- If your company merged with another company, a copy of the merger agreement
- If your company was dissolved, a copy of the articles of dissolution
Mail the completed claim form and documents to the following address:
- City of Napa - Finance Department
PO Box 660
Napa, CA 94559-0660
When our office receives your completed claim form, we review it carefully. If the evidence is not adequate to prove your ownership, or if a subsequent payment has been processed, our office will contact you or return all documents submitted with a letter stating why the claim is incomplete or being denied. Please allow 4 to 6 weeks processing time.
For questions or additional information, please contact the City of Napa Finance Department at 707-257-9510 or by email.