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Washington state law (Chapter 4.92 RCW) requires a Standard Tort Claim Form to be submitted when filing a tort claim against Catalyst Public Schools.  Standard Tort Claim forms cannot be submitted electronically (via email or by fax), but must be mailed or delivered to the address noted below.

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Required By Law

Engrossed Substitute House Bill 1553, effective July 26, 2009, requires citizens to present the Standard Tort Claim form with the government agency named in their claim. The law also requires State and local government agencies to post the Standard Tort Claim form on their websites with instructions on how to complete the form. In compliance with these requirements and for the convenience of citizens.

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Legal Requirements for Presenting Standard Tort Claim Forms

In order to verify the claim and additional supporting information, the law requires that the Standard Tort Claim form be signed by:

• Claimant; or

• Person holding a written power of attorney from the Claimant; or

• Attorney in fact for the Claimant; or

• Attorney admitted to practice in Washington State on the Claimant’s behalf; or

• A court‐approved guardian or guardian ad litem on behalf of the Claimant

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Present in Person or Mail the Standard Tort Claim Form and Supporting Documents to:

Catalyst Public Schools
Attn:  Amanda Gardner, Co-Founder and Superintendent
1305 Ironsides Avenue
Bremerton, WA 98310

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School Year Business Hours:  Monday-Friday, 7:30 a.m. to 4:30 p.m.
Summer Business Hours:  By appointment Monday-Friday between 9 a.m. and 4 p.m. 
Closed on weekends and official state holidays unless otherwise posted.

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Instructions for Completing a Tort Claim Form

• Before presenting a Standard Tort Claim form, please read these instructions, the Standard Tort Claim form, and other appropriate forms in their entirety.

• Type or print clearly in ink and sign the Standard Tort Claim form.

• Provide all requested information and any available documents or evidence supporting your claim, such as medical records or bills for personal injuries, photographs, proof of ownership for property damages, receipts for property value, etc.

• If the requested information cannot be supplied in the space provided, please use additional blank sheets so your Standard Tort Claim form can be easily read and understood.

• The following are examples on how to complete the Standard Tort Claim Form (#SF 210):

   

1. Smith, Karen Michelle – 02/20/1965

2. 1234 College Way NW, Apt. 56, Seattle WA 98178

3. P.O. Box 910, Seattle WA 98178

4. Same (or residence at the time of incident)

5. (206) 123-4567 – (206) 987-6543

6. KMSmith@hotmail.com

7. 8/9/2010 8:00 a.m.

8. If the incident that caused the damages occurred over a period of time, please provide the beginning time and the ending time in item 8.

9. Washington, Thurston, Tumwater, Campus of South Puget Sound Community College, Building number 22. I-5, Southbound, Milepost 109, near the Martin Way Exit

10. Washington State Department of Transportation, Highway

11. Smith, Thomas Arthur, 1234 College Way NW, Apt. 56, Seattle WA 98178 (360) 4563456; Tow Truck Driver, Nisqually Towing  

12. Unknown

13. List all other witnesses having knowledge of the incident in question, with their names, addresses, and telephone numbers that are not listed within items 11 and 12. Also include a description of their knowledge. For example, if your sister was with you, when the alleged incident occurred, please include her name, address, telephone number, and indicate she witnessed the incident.

14. Please describe the incident that resulted in the injury or damages, specifically answering the questions who, what, where, when and why.

15. If you reported this incident to law enforcement, safety, or security personnel, please provide a copy of the report or contact information to the person you spoke with.  

16. Please provide all of your medical providers with their names, address, telephone numbers, and the type of treatment.  If you were treated for a personal injury, please include your medical records and bills.

17. Please attach any additional documents that support your claim.

18. Please provide the dollar amount for your damages, including your time loss, medical costs, property damage loss, etc. This amount should represent your opinion of total compensation.