CITY OF RIALTO
CITY CLERK'S DATE STAMP
CITY OF RIALTO
2023 APR - 7 PM 2: 34
LIABILITY
CLAIM FOR DAMAGES RECEIVED
CITY CLERK
TO PERSON OR PROPERTY
1. Claims for death, injury to person, or to personal property 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 (Gow. Code 5911.2) RETURN TO:
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:
RAYMOND RAYA
FULL NAME DATE OF BIRTH
San Bernardino ErA 92M HOME TELEPHONE NO.
HOME ADDRESS INCLUDING CITY, STATE & ZIP
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):
10/10/2022 TIME: 1: 37 DAMEOPM
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE:
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. 4323 Lilac Ave
RIaLto CA 92377
3. HOW DID DAMAGE OR INJURY OCCUR?
SEE Attachment
4. WERE POLICE AT THE SCENE? *YESNO WERE PARAMEDICS AT THE SCENE? •YES NO
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.
my car parked in drivewa, arrested with Charges
that wert never fika. Do Refect.
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:
Item/Date: Amount: $
Item/Date: Amount: $
CITY OF RIALTO
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM:
2023 APR -7 PA 2:34
ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date:
Item/Date: CAmouft$RK
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $
1. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: Alex Martiner NAME:
ADDRESS. ADDRESS:
Rialto dA 92377
TELEPHONE: TELEPHONE: | 1
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: | TELEPHONE: |)
DATE: TIME: •AM 0 PM DATE:
TIME: _ • AM 0 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. 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.
CURB
PARKWAY
SIDEWALK
I HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS T THOSE 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.
SIGNATURE OF CLAIMANT OR AGENT
Fernando Dominguez 04/06/23
TYPE OR PRINT NAME DATE
Brother
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 Dominiquez and
IALTO my brother Raymand Raya are filling this
Elaim against Rialto Police Department
OF
APR and Pepes towing: I woutd want
CITY the statement that i make to be
2023
considered included in and considered
with beg our Claim form.
II HOW DID DAMAGE OR INJURY OCCUR?
on October 1th 2022 myself |zernando
Domingulz) and my brother Raymond Raya
were driving on Riverade Are and saw
our friend Alex martined which he was
making a left turn than a D torn onts
Riverside sur. me and my borather Raymond
Raya had stopped to say to Alep made
@ onto Casmalia driving up casmalia
my brother (Raymond Raya) and I seen
a Rialto Police venice heading & on Cismalia
and made a Whorn and got behind me
(Fernando Domingne my brather Raymond
Rayh had parked in our friends arveway
(John motley) at l323 Lilae Ave Rualto cA
and Raymond Raya got out of his vehicle
my vehicle (Fernando Domingles) parked
pagez
my vehicle by the corb.Both keys were
out of ignition. At offiter Ramand
Worked 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 brother Raymond Raya that
he was taking wis cur before he ran
his name and told him "weren't you the
Gie I had detained the day before."
my brother Raymond Raya told officer
Ramano he never seen him in his life.
After my brother said that to officer
Ramane, my brother was hancuffed
and was told his car wasbeing impounded
for Driving with a suspended license and
ny vehice was also impounded bu
ticer Ramand of seen at a crime scene
that was commutted. Both vehicles
were registered with up to date Tags
and insured. my vehide had mine
and my wifes name marissa Barros
on he registration. da Ranto PD could
Of left our vendes there but instead
Impounded them. me and My brother
Raymond Raya were arrested on 1o/10/22
for charges Ramans had wrote down
P9. 3
Which were: Burglary and conspiraly
to commit a crime. we were detarned
at west Valley Detention center for
3 Days. We were released on october
1th due to Charges never filed -(DARegeet
on my brothers release paperwork In cidcated
The Rallto PD was looking for a BLUE
Escalade. Mine and my brothers vehicles
are pearl white. odd Feety yuy brother
Pas one Riya never got his ho Back ance
released. my wallet was not with my
property when I was released.
on Friday october. 144h 2022 me
and my brother came down to Rialto
Police Station to file a complaint
and asked where the rest of our property
was at. officer Rocky Johnson said to
eman the officer that had your
property. Which was Offleer a Sanchez.
and to file a complaunt 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 we lmy brother and 1)
went to Pepis Towing and I lter nando
Doming her got all my things out of
puge 4
ny vehicle my brother Raymond Raya
asked a gentleman at Pepes 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 genreman of he
cun get it for him and said heND"
That night my brother Raymond Rays
had gone to the San Bernardind
Community Hospital in San Bernarding
Emeryency 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 8I100 or 50 plus 3200
release from Ricto PD. my brother also.
contacted the watch Commander and explained
What happend and asking the watch Conmander
If the his car was taken doe to a suspended
License wouldn't it be on his charges when
booked at west Valley Detention with the
other booking Charges that was dropped.
The watch conmander said Thie of fieers
don't have to gove 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 sad there was nothing
he can do.
A. Cople days later both of us (my
brother Raymond anal gut a letter from
Recito Po with the towing impound info. Which
The letter suidto contact a numberthat
was (909) 820-2578 to request an
Impound hearing and paying a fee to the
police department, release of $ 214. 80
October 19 2022 t. Ferrando Reminguez
went buck to Rialto Polier station
to see abort scheduling an impoud
hanny and to see why I had to
do this if no charges was filed and
it was a DA Reject and my Car
was indicated on impend paperirak
that it was in storage Offieer Rocky
Jonnson said! wasn't eligible to do
this hearing because my car was
not on a 30 day hold. And still wented
ine to pay the fees, Do I was upset
and left.
on movember It 2022 my wife Marisss.
Buros contacted Leutenanskelf regarding
this matter, The phone call was on
speaker phone 80 I (Fernands Doningue)
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 vehicles buck to
us (Raymond Raya a pernando
Dominguez) ON Movember 15th 2022
Laymond Raya and mysers fernando
Dominguez went to Rancho Court house
and git a Letter from the DA stating
all fees be waid and No Charges
were filed. And the Distries Attorney
told me and Raymond to give
copy to Rualto PD.
Nov Ie went back to Palalto PD
and officer Rocky Johnson Sard he
didn't care what that letter said that
he and Raymond Raya still has
to pay the fees.
Than me and Raymond went to SB
superior court to file a Tow hearing
and the judar said if we had whe
chicle repon that he word release
or curs
we want back to us paster hunche
And Ford i one to ten did
p9. 7
not have to gue him a ticket he can
Subpeona him.
ON Noo 22nd went back to
Rianto PD indicating about the tees
and our curs. Anally officer Rocky
Sonnoon signed and waived the fees
and to give paperwork to Pepes Towing.
Called Pepes towing and our vehicles
were at tontana yurd and was
sold by Pepis tourng that we still
Had to pay the Se 3000 had to pay the $t300D fees and
Hea ignored the DA Letter..
our vehicles were Auctioned on NOV. 23
2u22. and mus brother Raymond
Saying Raya a tid yus worn getting your.
car buck.
In summary we feel our aul poghts
were molated and being tals fully arrested
on bogus charges when there was no
officers at the scene where they
indi cuted happened.