CITY OF RIALTO
CITY OF RIALTO CITY CLERK'S DATE STAMP
2023 APR - 7 PM 2:34
LIABILITY
RECEIVED
CLAIM FOR DAMAGES CITY CLERK
TO PERSON OR PROPERTY
1. Claims for death, injury to person, or to personal praperty must be filed not later than six (6) months after the occurrence (Gov. Code 5911.2).
2. Claims for damages to real property must be filed not later than one (1) year after the occurrence (Gov. Code 5911.2).
3. READ ENTIRE CLAIM FOR BEFORE FILING Rialto City Clerk's Office
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mail: 150 S. Palm Ave., Rialto, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
Fernando Dominguez
FULL NAME DATE OF BIRTH
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO. chino Hills cA 91709
BUSINESS ADDRESS INCLUDING CITY, STATE-& ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: 10/10 / 22 TIME: 1^32 DAMIZM
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (if applicable) locate on diagram on reverse side of this sheet.
Where appropriate, give street names and addresses, measurements and landmarks. 6323 Lilac Ave
Rialto CA 9237?
3. HOW DID DAMAGE OR INJURY OCCUR?
a see Attachment
4. WERE POLICE AT THE SCENE? A'YES C NO WERE PARAMEDICS AT THE SCENE? DYES ENO
5. WHAT PARTICULAR ACT OR OMISSION DO YOU CLAIM CAUSED THE INJURY OR DAMAGES? Give the name of the city/town employee causing the injury or damage, if known.
Raya's car was Already Barked in Driveway My
cur was purked on the street we were ear arrested
with charges That were never filed, DA reJect
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
tem/Date: Amount: $
Item/Date: Amount: $
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLA:M:
ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: Amount: $_
Item/Date: Amount: $_
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: Alex MartiNEz
NAME:
ADDRESS: ADDRESS:
Rialto da 92 377
TELEPHONE TELEPHONE: | )
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: NAME:
ADDRESS: ADDRESS: _
TELEPHONE: | ). TELEPHONE: | ).
DATE: TIME: •AM • PM DATE: TIME:
• AM • PM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following diagram, the names of streets, including NORTH, EAST, SOUTH AND WEST directions. Indicate place of accident by "X" and by showing house numbers or distances to street comers.
If a city/town vehicle was involved, designate by letter "A" location of the City/Town vehicle when you first saw it, and by "B" location of yourself or your vehicle when you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and location of yourself or your vehicle at the time of the accident by "B-1" and the point of impact by "X".
→ NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMANT. 2023 APR - 7
CURB CITY OF RIALTO
PARKWAY
242:34
SIDEWALK
HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS T HOSE MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF; AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRUE I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
N
SIGNATURE OF CLAIMANT OR AGENT
Fernando Dominguez 04/07/23
TYPE OR PRINT NAME DATE
Self
-
RELATIONSHIP TO CLAIMANT
NOTE: PRESENTATION OF A FALSE CLAIM IS A FELONY (CA PENAL CODE 72) RETURN CLAIM TO: RIALTO CITY CLERK'S OFFICE - 150 S. PALM AVE., RIALTO, CA 92376 04/01 | 23
To whom it may concern:
2: 34 my name is Fernando Dominiquer and
L TO my brother Raymand Raya are filing this
Claim against Rialto Police Department
APR - 7 and Pepes Towing, I wood want
CITY The statement that i make to be
considered included in and considered
with boog our Claim form.
II HOW DID DAMAGE OR INJURY OCCUR?
on october 10th 2022 myself |zernando
Domingulz) and my brother Raymond Raya
were driving on Riverade Are and saw
our friend alex martines which he was
making a left turn than a D turn onts
Riverside sue, me and my borather Raymond
Raya had stopped to say to Aler made
a @ onto Casmalia driving up casmalia
my brother (Raymond Rays) and I seen
a Rialto Police venice heading E on Cismalia
and made a Whorn and got behind me
(Fernando Dominguez my brother Raymand
Rayh had parked in our friend's arveway
(John motley) at 1323 Lilac Ave Rualto CA
and Raymond Raya got out of his vehicle
my vehicle (Fernando Dominglies) parked
pagez
my vehicle by the curb. Both keys were
out of ignition. Doe officer Ramano
Walked up to Raymond Raye and said
for him to get back into the car and
told mel Fernando Dominguez that if
I moved he was going to shoot me.
He told my brare Paymond Rat Her. he was taking wis cur his name and told him "weren't you the
oie I had detamed the day before."
my brother Raymond Raya told officer
Ramano he never seen him in his life.
After my brother said that to officer
Ramans, my brother was hancoffee
and was told his car wasbeing impounded
for Driving with a suspended license and
my vehice was also impounded be
officer Ramans of seen at a crime scene
that was committed. Both vehicles
were registered with up to date Tags
and insured. my vehide had mine
and my waites name marissa Barros
on he registration. to Ranto PD could
of left our vendes there but instead
Impounded them, me and My brother
Raymond Raya were arrested on 'l10122 for charges Ramand had wrote down P9.3
Which were: Burglary and conspiracy
to commit a crime. we were detained
at west Valley Detention center for
3 Days, We were released on October
1th due to Charges never filed - (DARget
on my brothers release paperwork In didcated
the Riallto PD Was looking for a BLUE
Escalade. Mine and my brothers vehides
are pearl white. ost Feday my brother
Raymond Raya never got his ID Back and
Was not with has property when he got
released. my wallet was not with my
property when I was released.
On Friday October. 14 2022 me
and my brother came down to Rialto
Police Station to file a complarit
and asked where the rest of our property
was at. Officer Rocky Johnson Said to
many the officer that had your
property. Which was Offleer a sanchez.
and to file a complant we had to
go across the street to city Hall.
me and my brother Raymond filed
a complaint that duy. After we filed
the complaint welmy brother and 1)
went to Pepis Towing and I (ter nando
Domingkes got all my things out of
page 4
nu vehicle my brother Raymond haye
asked a gentleman at repes towing it he
can get his medication that he has to
Take on a daily basis. The gentleman
told my brother Raymond Raya "ND"
Ruymond asked him the genieman of he
cun get it for him and said he "ND"
That night my brother Raymonde Rays
had gone to the san Bernardind
Community Hospital in San Bernardino
Emergency Roomdue to having Chest
pains.
on tuesday October 18th called
Pepes towing to see how much it was
to get our car out and in formed us it was
already up to 81100 ur 50 plus B200
release from Ricto PD. my brother also.
contacted the watch Commander and explained
What happend and asking the watch Connender
If the his car was taken dee to a susponded
License wouldn't it be on his charges when
booked at west Valley Detention with the
Ather booking Charges that was dropped.
The watch Conmander said Thie of fiers
don't have to give you a ticket they
will subpeone you. That seems odd
When how are you supposed to go to court
puges
With out a case # and date All the
watch commander sand there was nothing
he can do.
A couple days later both of us (my
brother Raymond anal gut a letter from
Recity Do with the towing impound info. Which
the letter snidto contact a number that
was (909) 820-2578 to request an
Impound hearing and paying a fee to the
police department, release of $ 214. 80
October 19 2022 + Ferrando Dominguez
went buck to Rialto Polier station
to see abort scheduling an impound
hanny and to see why I had to
do this if no changes was filed and
it was a DA Reject and my Car
was indicated on impand paperink
that it was in storage Officer. Rocky
Jonnson said! wasn't eligible to do
This hearing because my car was
not on a 30 day hold. And still wented
the to pay the fees. Do I was upset
and left.
On Movember Ith 2022 my wife Makesss
Buros contacted Leutenanskelf regending
this matter, The phone call was on
speaker phone so I (Fernands Doninguey)
раде 4
Can be a witness Of what was
Said. Leutenant skelf had said if
I brought a letter from the DA
Stating ALL FEES BE WAlED than. he
will release the chicles back to
4s (Raymond Raya a Fernando
Dominguez ON. Movember 1572022
raymond kana and mysele Fernande
Dominguez went to Rancho Court house
and got a Letter from the DA stating
all fees be ward and No Charges
were filled. And the District Attorney
told me and pannena to gieie
Nov Ie went back to Ratto PD
and officer Rocky Johnson Saud he
didn't Care what that letter said that
me and Raymond Raya still hac
to pay the fees.
Than me and Raymond went to SB
superior court to file a Tow hearing
and the judge said if we had she
Vehicle repon that he word release
or curs back to us After lunch
he went back to the corkt and the
judge had changed has mind..
And told my brother the officer did
pg. 7
not have to gue him a ticket he can
Subpeona him.
ON Nou 22nd went back to
Rianto PD indicuting about the tees
and or curs. Anally officer Rocky
Sonneon signed and waived the fees
and to glue paperwork to Pepes Thing.
Called Pepes towing and our vehicles
were at tontana yard and was
told by pepes touring that we still
had to pay the $t3000 fees and
tea ignored the DA Letter..
our venudes were Auctroned on MOV.23
Load. and my brother Raymond.
Raya aut a call from an officer
saying told you weren't getting your
car back.
In summary we tell our all Doghts
Were molated and being tals fully arrested
on bogus charges when there was no
officers at the scene where they
indi cuted happened.