Claim Form

Jurisdiction: Country: United States | Province or State: Ohio

What Is a Claim Form?

A Claim Form starts a case in the Ohio Court of Claims. You use it to ask for money from the State of Ohio or a state agency. It is the first pleading in your lawsuit. It tells the court who you are, who you are suing, and why. It also states how much you want and what facts support your request.

You typically use this form when the State, a state agency, or a state employee caused you harm. Your claim can arise from negligence, a contract, or another legal duty. For example, you may have property damage tied to state road work. You may have injuries from an incident on state property. You may have a dispute over a state contract or grant. You may have an employment or discrimination issue with a state office. You may be a vendor who has not been paid. You may be a student with a billing dispute at a state university. If the defendant is part of the State of Ohio, this is the court you use.

You would not use this form to sue a city, county, township, or school district. Those are local governments. They are not part of the State. You also would not use it against a private business or a person who is not a state employee. Those cases belong in other courts. If your dispute is only about access to public records, a different process applies. That has its own form. Crime victim compensation also uses different forms. This Claim Form is for civil money claims against the State.

You may file as an individual or a business. You can also file if you are an estate’s executor or a guardian. Some claims involve inmates or former inmates, such as lost property issues. Some involve contractors or professional services. Some involve medical care received at a state-run facility. The key factor is the defendant. If your target is the State of Ohio or one of its agencies, this is the correct forum.

The form asks for facts, not just conclusions. You need to state what happened, when, and where. You should also explain how the State’s actions caused your loss. The court will not assume details that are missing. Be specific and keep everything truthful. You sign the form to certify the information.

When Would You Use a Claim Form?

You use the Claim Form when you want damages from the State or a state agency. You might have hit a pothole on a state-maintained highway and paid for repairs. You might have slipped on a spill in a state office building. You might have had a state contract terminated without cause. You might have been underpaid on an invoice for delivered goods. You might have medical bills from care at a state hospital. You might have lost personal property while in state custody. You might have been denied a benefit that a statute requires. In each case, the defendant is tied to the State.

Tenants, landlords, and neighbors usually do not use this form. Those disputes are commonly private and belong in other courts. A landlord seeking rent from a tenant is not suing the State. A neighbor’s fence dispute also does not involve the State. A small business seeking payment from another private company would not use this court.

On the other hand, a vendor that provided goods to a state department would use this form. A student disputing a fee assessed by a state university could use this form. A job applicant alleging discrimination by a state office might also use this form. An employee of a state agency who claims unpaid wages would file here. A motorist alleging a guardrail defect on a state route would use this form. If a state employee injured you while acting in their job, you can pursue the State here. The court may decide whether the employee is immune and whether the State is responsible.

You also use this form if you want a more streamlined track for smaller claims. If your claim is $10,000 or less, you can ask for an administrative determination. That is a simplified process. It limits formal procedures and can move faster. If your claim is above that amount, your case follows the standard process.

Legal Characteristics of the Claim Form

The Claim Form is legally binding because it starts a lawsuit. Once the clerk accepts it and the fee is paid, a case exists. The court assigns a case number. The State is notified. Deadlines begin to run. You cannot file the same case in a different court while this is pending. You also cannot sue for the same damages elsewhere after judgment.

The form must assert the court’s jurisdiction. The Ohio Court of Claims hears cases against the State and its agencies. It does not have jurisdiction over cities or counties. If you name a non-state defendant, the court could dismiss your case. That is why you must identify the right defendant and agency. The caption should reflect the State as the defendant, and also name the specific agency involved. This shows the court has the power to decide the dispute.

Your signature carries legal weight. By signing, you certify that your statements are true to the best of your knowledge. You also certify that your claim is made in good faith. False statements can lead to penalties. Frivolous claims can result in sanctions. Always keep your facts accurate and your amounts supportable.

Enforceability comes from following the rules. The court must have jurisdiction. Your claim must be filed before the deadline for your legal theory. The court must properly serve the State. The form must include facts that state a claim. The demand for damages must be clear. If you meet these basics, the court can issue binding orders and a final judgment.

Judgments from the Court of Claims are enforceable against the State. Payment follows state procedures for judgments. You may recover court costs if the law allows. Interest may be available in some cases, depending on the claim and statutes. Punitive damages are rarely available against the State. You should focus on actual losses that you can prove. The court may also award equitable relief only in limited circumstances, usually tied to money claims. This court’s core role is resolving monetary disputes with the State.

If your claim is for $10,000 or less and you choose the administrative track, the court can decide the case on written submissions. Hearings are limited and informal. Discovery may be restricted. The decision still has the force of a judgment. If you want full civil procedures, you can choose the standard track. That allows more discovery and motion practice. It can take more time and cost more to litigate.

You should also consider immunity issues. State employees often have immunity for acts within their job duties. The court may decide if the employee acted within those duties. If so, the State can be the only defendant for those acts. If not, claims against the individual may proceed elsewhere. The Claim Form helps frame that question. Be precise about who did what, and in what capacity.

Protect confidential data in your filing. Do not include full Social Security numbers. Do not list full bank or medical account numbers. Redact personal identifiers. If the form asks for such data, use only the last four digits when possible. Attach sensitive records only when needed, and consider redaction. The court can strike filings that reveal protected data.

How to Fill Out a Claim Form

1) Decide your claim type.

• Confirm the defendant is the State of Ohio or a state agency. If not, stop. This is not the right court.
• Decide if your total claim is $10,000 or less. If yes, you can request the administrative determination track. If no, you will use the standard track.

2) Gather your facts.

• List the date, time, and location of the event. Identify the county. Note the facility or roadway if relevant.
• Identify the state agency involved. Use its official name. Add the division, unit, or campus if applicable.
• Write a clear timeline. Keep each step factual. Avoid speculation.

3) Calculate your damages.

• Add up out-of-pocket costs. Think repairs, medical bills, and replacement costs.
• Add lost wages or revenue if you claim them. Explain the time missed and pay rate or revenue loss.
• Include contract amounts owed or penalties charged to you, if relevant.
• For future losses, explain the basis. Use estimates or expert opinions if you have them.
• Total your demand. Be realistic. The number must match your evidence.

4) Complete the caption.

• Identify yourself as the claimant or plaintiff. Use your full legal name.
• List the defendant as the State of Ohio. Also, name the specific state agency underneath or alongside. This ties the State to the facts.
• Leave space for the case number. The clerk will assign it.

5) Provide your contact information.

• Add your mailing address, phone number, and email. Keep this current.
• If you have a lawyer, list the lawyer’s name, address, phone, and registration number. Your lawyer will sign the form.

6) State jurisdiction and venue.

• Check the box or write that the defendant is the State or a state agency. That invokes the court’s authority.
• Identify the county where the event occurred. This helps with scheduling and any remote hearing plans.

7) Describe your claim (Statement of Facts).

• Write short, numbered paragraphs. Use dates and names. Example: “On March 3, 2024, I was driving east on …”
• Identify the state employees involved, if known. State their titles if you know them.
• Explain what each person did or failed to do. Tie their acts to the agency.

8) Explain your legal basis.

• State the theory in plain terms. Examples: negligence, breach of contract, or wage claim.
• Do not argue case law. Just connect the facts to your theory. Example: “The agency failed to maintain the premises.”

9) Specify damages and relief (Demand).

• List the exact amount sought. Break it into categories if possible.
• Ask for court costs as allowed. Include interest only if applicable to your claim type.
• If you want the administrative determination track, affirm that your total is $10,000 or less.

10) Attach schedules and exhibits.

• Schedule A: Facts. Include a timeline, photos, or maps if helpful.
• Schedule B: Damages. Include bills, estimates, invoices, and pay records.
• Schedule C: Contract Documents. Attach the contract, amendments, and correspondence.
• Schedule D: Medical or Expert Support. Include reports or letters supporting causation and damages.
• Label each page with the schedule letter and page number.

11) Identify witnesses and evidence.

• List names and contact details for witnesses if you have them.
• Describe key documents. State where originals are held.
• If you do not have an item yet, note that you will supplement.

12) Address prior or related cases.

• State if you filed the same claim elsewhere. If yes, explain the outcome and current status.
• State if you made a prior administrative claim to the agency. Describe the response and date.

13) Add any special requests.

• If you need a language interpreter, say so.
• Note any disability accommodations you need for hearings.
• If you prefer remote proceedings, state your preference. The court decides based on its rules.

14) Review confidentiality.

• Redact personal identifiers. Use only the last four digits for any sensitive number.
• Black out account numbers. Remove birth dates except for month and year if needed.
• If you must include sensitive records, ask the court to permit filing under seal if appropriate.

15) Sign and date.

• Read the form again. Check names, dates, and amounts.
• Sign the certification. By signing, you affirm the truth of your statements.
• If you are a business, an authorized officer should sign. Add the title and authority to sign.

16) Prepare copies.

• Make one copy for you and one for each attachment set. The clerk keeps the originals.
• Ensure each copy is complete and legible. Check exhibit labels and page order.

17) Pay the filing fee and file.

• Confirm the current filing fee with the clerk before you file. Fees depend on your track.
• File in person, by mail, or through any accepted electronic method. Follow the court’s instructions.
• Keep your receipt and any filing confirmation.

18) Service of process.

• The clerk arranges service in the State. Provide accurate agency information to avoid delays.
• If you are asked to provide envelopes or addresses, supply them promptly. Use official mailing addresses for the agency.
• Track service status. If service fails, correct the address and request new service.

19) After you file.

• Watch for a scheduling order or response deadline. The State will respond through counsel.
• Meet any deadlines for disclosures or submissions. If you choose administrative determination, prepare your written evidence promptly.
• If the court sets mediation or a conference, attend and participate in good faith.

20) Common mistakes to avoid.

• Do not name a city, county, or private party as a defendant. This court cannot hear those cases.
• Do not file after your deadline has passed. Check your statute of limitations for your claim type.
• Do not ask for non-monetary relief that the court cannot grant. Focus on money damages.
• Do not inflate damages. Unsupported amounts hurt your credibility.
• Do not omit key facts like dates, locations, and agency names.

Practical example: You hit debris that fell from state-maintained equipment. Your car needs $2,800 in repairs. You choose the administrative track. In your Statement of Facts, you list the date, route, mile marker, and time. You attach repair estimates and photos. You name the state agency responsible for maintenance. You explain why the State’s negligence caused your damage. You demand $2,800 plus allowed costs. You sign, file, and provide the agency address for service. The court reviews your papers and sets a submission schedule.

Another example: Your small business delivered software under a state contract. The agency did not pay the last invoice of $47,000. You choose the standard track. You attach the contract, purchase orders, acceptance emails, and the unpaid invoice. Your statement explains the work, delivery, acceptance, and nonpayment. Your demand seeks the unpaid amount, plus the late fees allowed by the contract. You request a scheduling order and prepare for discovery.

Final tip: Keep your presentation simple and accurate. Judges value clear facts and documented losses. Short, organized paragraphs are best. Attach only what helps. Label everything. If you need to amend your claim later, you can seek permission. File early and keep copies of all filings and mailings.

By following these steps, you give the court what it needs. You show that your claim fits the court’s authority. You present a clear story with proof. You set yourself up for a fair review and a timely decision.

Legal Terms You Might Encounter

• Claimant means you—the person filing the claim. On the form, you list your full legal name and contact details as the claimant so the court and the state know who is making the claim.
• Defendant means the party you are suing. In this court, that is the State of Ohio or a specific state agency, university, or instrumentality. On the form, you will identify the correct agency by name so the case is routed to the right place.
• Jurisdiction is the court’s power to hear your case. The Ohio Court of Claims handles civil claims against the state, not against cities, counties, or private parties. On the form, make clear that the state or a state agency caused your loss. If a local entity is responsible, this is not the correct court.
• Venue is the location where the case is filed and handled. This court has statewide venue for claims against the state. You do not pick a county court. Filing the form with the Court of Claims clerk is the step that starts venue properly.
• Damages are the money you seek to recover. On the form, you will state an amount or describe how you will calculate it. You should tie the amount to actual losses, like medical bills, repair costs, or contract losses, and attach documents that support the total.
• Statement of Facts is your plain-language account of what happened. On the form, you will use simple dates, names, locations, and actions to explain how the state or its agency caused your loss. Keep it factual and organized; avoid opinions and legal arguments.
• Exhibits are the documents you attach to support your claim. These can include invoices, photos, contracts, emails, or reports. On the form, you should label each exhibit clearly and refer to it in your Statement of Facts so the reader can connect the proof to the claim.
• Verification is your signed statement that the facts in your claim are true. The form will require your signature. Some filings also require you to affirm under penalty of perjury. Make sure the information is accurate and complete before you sign.
• Service is the formal delivery of your filed claim to the opposing side. In this court, service goes to the state’s legal representative. Follow the form’s guidance so the Attorney General or designated counsel receives it. If the service is not done correctly, your case can be delayed.
• Affidavit of Indigency is a sworn statement asking the court to waive filing fees due to financial hardship. If you cannot afford the fee, you may attach this affidavit to the form or file it with your claim. You must provide accurate income and expense information to support the request.
• Mediation is a confidential settlement conference facilitated by a neutral person. Your case may be referred to mediation after the form is filed. The form’s clarity helps a mediator understand your position, your damages, and what a fair resolution might look like.
• Magistrate is a judicial officer who may handle parts of your case. A magistrate can conduct hearings and issue decisions. Your clearly completed form helps the magistrate grasp the issues early, which can speed up scheduling and rulings.

FAQs

Do you have to name the exact state agency?

Yes. You should name the specific agency, university, or department that acted or failed to act. If you only write “State of Ohio” without naming the agency, the case can be delayed while the court or the Attorney General identifies the right entity. Check any letters, contracts, badges, or invoices you have to confirm the proper name.

Do you need to list a dollar amount of damages?

Yes, if you can. State a total or provide a good-faith estimate and explain how you calculated it. Use bills, repair estimates, wage records, or contract figures to support the number. If some losses are ongoing or not yet final, say so and state the best estimate. You can later update the amount if the court allows.

Do you need to attach evidence when you file?

You should attach key documents that support your claim. Include photos, medical bills, repair invoices, contracts, emails, or agency reports. Label each exhibit and refer to it in your facts. You can add more evidence later during the case, but strong initial exhibits help the court and the state understand your claim quickly.

Do you need to have the form notarized?

The claim form requires your signature and may include a verification or declaration. Notarization is not always required. Follow the signature block instructions on the form exactly. If notarization is required for any affidavit, sign in front of a notary as instructed. Do not sign in advance if a notary is needed.

Do you have to serve the Attorney General yourself?

Service must follow the court’s rules. Some filings are served by the clerk; others may require you to send a copy by approved methods. The form will tell you how the service occurs. If you must serve, use the method allowed and keep proof of delivery. Improper service can delay or dismiss your claim.

Can you file one claim for multiple incidents?

You can describe related incidents if they involve the same parties and legal issues. If the incidents are separate in time and cause, you may need to file separate claims. Use clear dates and explain how each event ties to your damages. Avoid mixing unrelated matters in one filing.

Can you amend your claim after filing?

Often, yes, with court permission or as allowed by the rules. If you discover new facts, need to correct a name, or must adjust damages, you can request to amend. File your request promptly and attach the proposed changes. Delays can affect scheduling and may require the court’s approval.

What happens after you file?

You receive a case number. The state’s counsel reviews your claim. You may receive a request for more information, a mediation notice, or a schedule for initial proceedings. Keep your contact details current. Respond to all letters by their deadlines. If you applied for a fee waiver, wait for the decision before assuming your case is active.

How long does the process take?

Timeframes vary. Factors include the complexity of your claim, the court’s schedule, the parties’ availability, and whether the case settles. Early settlement can happen quickly if your form is complete and supported. If the case proceeds through discovery and a hearing, expect a longer timeline.

What if the harm was caused by a city or county?

This court handles claims against the state and its agencies. Cities, counties, and other local entities are not the same as state agencies. If your facts point to a local entity, this may not be the right court. Review your documents carefully to confirm the correct defendant before filing.

Checklist: Before, During, and After the Claim Form

Before signing

• Identify the correct defendant.
• Confirm the full legal name of the state agency, university, or department.
• Check contracts, letters, invoices, or ID badges for exact names.
• Confirm jurisdiction.
• Make sure your claim is against the State of Ohio or a state agency.
• Gather facts and documents.
• Timeline with dates, locations, and key people.
• Contracts, correspondence, invoices, receipts, and photos.
• Medical records or repair estimates if relevant.
• Any written decisions or reports from the agency.
• Calculate damages.
• Add up out-of-pocket costs and lost income with proof.
• Note ongoing or future losses and how you estimated them.
• Prepare exhibits.
• Label each document (e.g., Exhibit A, Exhibit B).
• Redact sensitive information you do not need to share.
• Check deadlines.
• Note any limitation periods that may affect filing.
• Decide on fee payment.
• Prepare the filing fee or complete an affidavit of indigency with supporting details.
• Confirm your contact information.
• Use an address where you can receive mail reliably.
• Add email and phone if the form allows.
• Consider settlement documents on hand.
• If you have a demand letter or a response, include it.

During signing

• Review each section for accuracy.
• Claimant name, address, and contact details.
• Correct defendant agency name.
• Clear Statement of Facts with dates and locations.
• Damages total and explanation.
• List of exhibits attached.
• Verify the signature block.
• Sign on the correct line as the claimant.
• Add the date, printed name, and title if filing on behalf of a business.
• Check any verification or declaration.
• Ensure the facts are true and complete.
• Handle notarization if required.
• Do not sign until in front of a notary if an affidavit requires it.
• Final proofread.
• Check spelling of names, addresses, and dollar amounts.
• Confirm exhibit labels match references in the facts.

After signing

• Make copies.
• Keep a full copy of the signed form and all exhibits for your records.
• File the claim.
• Submit the form to the Court of Claims clerk with the fee or fee-waiver request.
• Confirm receipt.
• Obtain a stamped copy or other confirmation and the case number.
• Complete service as required.
• Follow the instructions to ensure the state’s counsel receives your claim.
• Keep proof of service.
• Track deadlines.
• Note any dates for responses, mediation, or hearings.
• Monitor mail and email.
• Respond promptly to court notices and requests for information.
• Organize your case file.
• Keep a timeline, correspondence log, and an exhibit list.

Common Mistakes to Avoid

• Misnaming the defendant. If you sue the wrong party or use an incorrect agency name, your claim can be delayed or dismissed. Don’t guess. Check your documents for the exact legal name and verify the agency’s role in your loss.
• Leaving out key dates and facts. Vague narratives make it hard for the court and the state to understand what happened. The result is requests for clarification or a weaker position in settlement. Don’t forget to include a clear timeline with who did what and when.
• Failing to attach proof. Unsupported damages or missing exhibits can lead to denials, low settlement offers, or extended discovery. Don’t forget to attach bills, photos, contracts, and other documents that tie to your claimed amount.
• Skipping the damage calculation. If you don’t state a total or explain how you calculated it, you reduce clarity and leverage. Don’t forget to provide a number and show how you reached it with exhibits.
• Ignoring service requirements. Improper service can pause your case or lead to dismissal. Don’t forget to follow the service instructions and keep proof of delivery.
• Using the wrong court. Filing a claim against a city, county, or private party in this court wastes time and fees. Don’t forget to confirm that your claim is truly against the State of Ohio or one of its agencies.

What to Do After Filling Out the Claim Form

File your claim promptly.

• Submit the signed form, exhibits, and the filing fee or fee-waiver request to the clerk. Keep proof of filing and note your case number. If your fee-waiver request is pending, watch for a decision; your case may not proceed until the court rules on it.

Complete service as instructed.

• Ensure the state’s legal representative receives a copy of your filed claim. If the clerk handles service, confirm that it occurred. If you must serve, use an approved method and keep tracking or delivery confirmation. Proper service starts the response clock.

Track your mail and email daily.

• The court or the state’s counsel may contact you to clarify facts, request documents, or schedule mediation. Missed letters lead to delays or missed deadlines. Update your address or email with the clerk if anything changes.

Prepare for early resolution.

• Organize your exhibits and damage summary so you can evaluate offers quickly. If mediation is scheduled, bring a concise timeline, your best damages calculation, and copies of key documents. Focus on the facts that drive liability and damages.

Respond to requests for information.

• If the state asks for specific records, provide timely, organized responses. Use a cover sheet that lists the documents you are providing. Keep copies of everything you send.

Consider amendments if needed

• If you realize you misstated a date, misnamed the agency, or discovered new damages, request to amend your claim as allowed. File the amended document promptly and provide a clean, corrected version with changes clearly shown.

Maintain a clean case file.

Keep a binder or digital folder with:

• The filed claim form and exhibits.
• Proof of filing and service.
• All letters, emails, and court notices.
• A running damages spreadsheet with sources.
• A timeline of events and contacts.

Prepare for hearings or conferences.

• If you receive a notice for a scheduling conference or mediation, review your claim, recheck exhibit labels, and bring copies. Be ready to discuss the key facts, damages, and any settlement terms you would accept.

Protect original evidence.

• Store photos, devices, invoices, and physical items in their current condition. Do not write on originals. If something must be inspected or tested, document its condition first.

Watch for a magistrate’s decision or orders.

• After hearings, you may receive decisions or scheduling orders. Read each carefully and calendar any deadlines for objections, disclosures, or next steps.

Plan your communications.

• Keep messages concise and factual. When you send updates or exhibits, label them consistently. If you change your contact information, notify the clerk and the state’s counsel immediately.

Reassess settlement as the case develops.

• Update your damages total as new costs arise or as you receive payments from other sources. Adjust your settlement range to match your latest documentation.

If you resolve the case, follow the closure steps.

• You may need to sign a settlement agreement or a dismissal entry. Confirm whether any payment requires tax reporting or offsets. Keep final documents in your file.

If the case proceeds to a decision, review the next steps.

• After a magistrate or judge issues a decision, calendar any deadlines for post-decision filings. Follow instructions carefully to preserve your rights.