updated November 20, 2021
Filling out the Paperwork
Only pages two, three, and four need to be completed. Below are suggestions you may find useful.
Page Two
#1 - Complete the top two lines with your name, phone number, and
address.
#2 - Name: The City and County of San Francisco
1 Dr. Carlton Goodlet Place, Room 200
SF CA 94102
It's a public entity: Name: Jocelyn Jackson, Mayor's Office
1 Dr. Carlton Goodlet Place, Room 200
SF CA 94102
#3 - Enter a monetary amount (up to $10,000) that you feel the City and County of San Francisco owes you for compensation.
#3 a - Enter why you feel the CCSF owes you money.
Page Three
#3 b - On "date started", the small claims department requires an
approximate month/year when you were first aware of the noise.
On "Through", enter when you stopped being affected or enter
today's date.
#3 c - Enter specific expenditures if you had/have to replace
your windows, et al. If you haven't incurred costs, enter what
comes to mind that you've had to endure, such as the loss of
tranquility, sleep, concentration, the smell of fuel, et al.
#4 - Check "yes".
#5 - Check "5c" - I personally enter "The cities that are in the SFO's
runway noise corridor are in San Mateo County."
#6 - Enter your zip code.
#7 - Check "No".
#8 - Check "Yes". Where it says "A claim was filed on (date)", look at
the letter from San Francisco. Its first sentence has your
claim date.
Page Four
#9 - You'll probably check "No".
#10 - Check "yes" or "no".
#11 - Enter the date. Type or print your name.
After the arrow, sign your name.
PRINTOUTS: AFTER FILLING OUT THE 3 PAGES, PRINT OUT 3
ADDITIONAL COPIES OF PAGES 2, 3, AND 4.
sallymeakin@yahoo.com