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File Your Claim

The owner of damaged property must notify the City of Midland of the damages no later than 60 days from the date of the incident.
You may either submit this form electronically by hitting the "submit" button or print and mail it to the City of Midland at the following address: Attn: Jamee Higgins, Risk Management Division, City of Midland, PO Box 1152, Midland, TX 79702
Date of the Incident/Damage*
Date of the Incident/Damage
Date of the Incident/Damage
Location where the incident/damage occurred*
PO Box/Apt #
City*
State*
Zip
Description of the damage*
Please be as specific as possible.
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What is being requested?
Please include specific dollar figures.
Please include photos of the damaged property.
Hit the "ctrl" button to select multiple files.
Please include at least two (2) repair estimates.
Estimate 1
Estimate 2

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