Online forms: Public Liability Claim Form

This form should be completed by a City of Wanneroo employee.  Do not allow the claimant to complete this form.

In order to complete this form you will need to gather the following details prior to submitting:

Witness details (if necessary)

• Name(s) and address(es) of witness(es)
• Whether the witness(es) opinion is that the accident/incident was caused or contributed to by any person other than an employee or agent and give the name of that person
• Details of such reason

Documentation to upload

• Copies of contract agreements
• Copies of inspection and/or maintenance programs (if applicable)
• Copies of hire agreements
• Copies of plans
• Photographs (if available)
• Diagrams of signs (if applicable)