[Date]
Marion County Legal Department / Risk Management
[Address of Marion County Legal Department or County Attorney]
Attn: Claims Coordinator
Re: Written Notice of Claim under the Indiana Tort Claims Act, Ind. Code § 34‑13‑3‑1 et seq.
To Whom It May Concern:
Pursuant to the Indiana Tort Claims Act, I hereby give written notice of claims against Marion County and its employees arising from the following occurrences.
1. Claimant
- **Name:** [Full name]
- **Address:** [Street, City, State, ZIP]
- **Phone:** [Number]
- **Email:** [Email]
2. Date(s) and Time(s) of Occurrence
- **Sign incident:** [Date and approximate time]
- **Fines assessed:** [Date(s) fines were assessed and dates of any notices or hearings]
- **Voting denial:** [Date and approximate time]
3. Locations
- **Sign location:** [Exact address or description of location where sign was displayed]
- **Fines assessed at:** [Office/agency/location that assessed fines]
- **Voting location:** [Polling place name and address]
4. Description of Occurrences and Basis of Claims
- **A. Sign (Compelled speech / unlawful enforcement)**
On [date], I displayed a political yard sign reading “[exact text of sign]” at [location]. An agent/employee of Marion County (or [name/agency if known]) [describe action: cited me, demanded removal, threatened fine, seized sign, etc.] citing [statute or ordinance if referenced]. This action constituted compelled speech and/or unlawful enforcement of a disclaimer/identification requirement in violation of the First Amendment and Indiana Constitution, and caused [describe harms: seizure, fines, emotional distress, lost use, etc.].
- **B. Fines assessed without jurisdiction**
On [date(s)], Marion County (through [agency/official]) assessed fines of $[amount] for [describe alleged violation]. At the time, the County lacked jurisdiction to assess these fines because [brief legal basis: e.g., ordinance not applicable, statute preempted, no authority, improper procedure]. I have paid / refused to pay / been billed for these fines and have suffered economic loss in the amount of $[amount].
- **C. Denial of right to vote**
On [date], at [polling place], I attempted to vote but was refused after I declined to present identification. The poll worker/official (name if known) prevented me from voting despite my eligibility and without lawful basis. This denial caused deprivation of my right to vote and resulted in [describe harms: inability to vote, emotional distress, lost opportunity, etc.].
5. Names of Government Employees Involved (if known)
- [List names and titles; if unknown, state “unknown” and identify agency]
6. Witnesses (if any)
- [Name, contact information, brief description of what each witnessed]
7. Injuries and Damages Claimed
- **Economic damages:** fines paid or owed $[amount]; costs to replace sign or repair property $[amount]; other out‑of‑pocket expenses $[amount].
- **Non‑economic damages:** emotional distress, humiliation, loss of constitutional rights — amount to be proven at trial.
- **Total claimed damages (approximate):** $[total or “to be determined”]
8. Medical or Other Treatment (if applicable)
- [List providers, dates, and amounts billed if any physical or psychological treatment occurred]
9. Supporting Documents and Evidence (attached or available)
- Photographs of the sign and location
- Copy of any citation, notice, fine assessment, or written demand
- Certified mail receipts and correspondence with county officials
- Witness statements
- Proof of payment of fines (receipts, bank records)
- Polling place records or incident report (if any)
- Any other relevant documents
10. Relief Requested
- Return of seized property (if applicable)
- Refund of fines paid $[amount]
- Compensatory damages for economic and non‑economic harm in an amount to be proven
- Costs and interest as allowed by law
Please direct all communications regarding this claim to the undersigned at the address above.
Sincerely,
[Signature]
[Printed Name]
[Date]
[Date]
Marion County Legal Department / Risk Management
[Address of Marion County Legal Department or County Attorney]
Attn: Claims Coordinator
Re: Written Notice of Claim under the Indiana Tort Claims Act, Ind. Code § 34‑13‑3‑1 et seq.
To Whom It May Concern:
Pursuant to the Indiana Tort Claims Act, I hereby give written notice of claims against Marion County and its employees arising from the following occurrences.
1. Claimant
- **Name:** [Full name]
- **Address:** [Street, City, State, ZIP]
- **Phone:** [Number]
- **Email:** [Email]
2. Date(s) and Time(s) of Occurrence
- **Sign incident:** [Date and approximate time]
- **Fines assessed:** [Date(s) fines were assessed and dates of any notices or hearings]
- **Voting denial:** [Date and approximate time]
3. Locations
- **Sign location:** [Exact address or description of location where sign was displayed]
- **Fines assessed at:** [Office/agency/location that assessed fines]
- **Voting location:** [Polling place name and address]
4. Description of Occurrences and Basis of Claims
- **A. Sign (Compelled speech / unlawful enforcement)**
On [date], I displayed a political yard sign reading “[exact text of sign]” at [location]. An agent/employee of Marion County (or [name/agency if known]) [describe action: cited me, demanded removal, threatened fine, seized sign, etc.] citing [statute or ordinance if referenced]. This action constituted compelled speech and/or unlawful enforcement of a disclaimer/identification requirement in violation of the First Amendment and Indiana Constitution, and caused [describe harms: seizure, fines, emotional distress, lost use, etc.].
- **B. Fines assessed without jurisdiction**
On [date(s)], Marion County (through [agency/official]) assessed fines of $[amount] for [describe alleged violation]. At the time, the County lacked jurisdiction to assess these fines because [brief legal basis: e.g., ordinance not applicable, statute preempted, no authority, improper procedure]. I have paid / refused to pay / been billed for these fines and have suffered economic loss in the amount of $[amount].
- **C. Denial of right to vote**
On [date], at [polling place], I attempted to vote but was refused after I declined to present identification. The poll worker/official (name if known) prevented me from voting despite my eligibility and without lawful basis. This denial caused deprivation of my right to vote and resulted in [describe harms: inability to vote, emotional distress, lost opportunity, etc.].
5. Names of Government Employees Involved (if known)
- [List names and titles; if unknown, state “unknown” and identify agency]
6. Witnesses (if any)
- [Name, contact information, brief description of what each witnessed]
7. Injuries and Damages Claimed
- **Economic damages:** fines paid or owed $[amount]; costs to replace sign or repair property $[amount]; other out‑of‑pocket expenses $[amount].
- **Non‑economic damages:** emotional distress, humiliation, loss of constitutional rights — amount to be proven at trial.
- **Total claimed damages (approximate):** $[total or “to be determined”]
8. Medical or Other Treatment (if applicable)
- [List providers, dates, and amounts billed if any physical or psychological treatment occurred]
9. Supporting Documents and Evidence (attached or available)
- Photographs of the sign and location
- Copy of any citation, notice, fine assessment, or written demand
- Certified mail receipts and correspondence with county officials
- Witness statements
- Proof of payment of fines (receipts, bank records)
- Polling place records or incident report (if any)
- Any other relevant documents
10. Relief Requested
- Return of seized property (if applicable)
- Refund of fines paid $[amount]
- Compensatory damages for economic and non‑economic harm in an amount to be proven
- Costs and interest as allowed by law
Please direct all communications regarding this claim to the undersigned at the address above.
Sincerely,
[Signature]
[Printed Name]
[Date]
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