City of Cincinnati
Law Department
Online Damage Claims Form
*First Name: * Required Fields
Middle (Initial or Name):
*Last Name:
*Street:
*City:
*State:
*Zip:
*Contact Phone: i.e. 513-256-4569
Cell Phone: i.e. 513-256-4569
Email:
*Insurance Information:
*Incident Date: i.e. mm/dd/yyyy
*Incident Time: i.e. 1:00pm
*Incident Location:
*City Department Involved:
*Description of Incident:
(Maximum 750 letters)
 

City of Cincinnati City Hall 801 Plum Street , Room 214, Cincinnati , Ohio 45202
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Phone: 513-352-1577