Home > Safety > Damage Reimbursement Request Form Damage Reimbursement Request Form Law enforcement and rescue activities can, at times, damage personal property. Generally, reimbursements of these types of damages are not the responsibility of the Ada County Sheriff's Office. If you believe ACSO deputies acted outside the scope of what was necessary and reasonable at the time, you may make a claim for reimbursement of the cost of repair that may be reviewed. Please note that in order for your claim to be considered, you must show that the deputies acted with a malicious purpose and actual intent to damage your property or acted in a wanton or reckless manner with reckless disregard of your property. Please describe your property, how it was damaged and provide details why you believe deputies acted in this manner.Information About YouLast Name* First Name* Middle Initial Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work PhoneCell PhoneEmail Information about the IncidentIncident Date* MM slash DD slash YYYY Time of Incident* : Hours Minutes AM PM AM/PM Report Number* Location of Incident* Damaged PropertyList property damaged and how it was damaged (please be descriptive)*List property damaged and how it was damaged (please be descriptive)Total Damage Claimed* All requests for damage reimbursement must be supported by two (2) bids from a licensed vendor.Upload Bid 1Accepted file types: pdf, jpg, png, doc, docx, Max. file size: 7 MB.Upload Bid 2Accepted file types: pdf, jpg, png, doc, docx, Max. file size: 7 MB.CAPTCHA