Attachment B.pdf

This is a South Carolina Department of Transportation (SCDOT) Damage Claim Form (Form 2062) used for filing claims related to vehicle damage, personal injury, or non-vehicular claims. The form requires claimants to provide comprehensive contact information, vehicle details, insurance information, and incident specifics including date, time, location, and damage amounts. For registered vehicle damage claims, the form requires two repair estimates or paid invoices to substantiate the claimed amount.

The form includes sections for documenting the incident location details, route/road information, and witness information. It concludes with an affidavit section requiring notarization of the claimant's signature to certify that the claim is true and that no compensation has been received from other sources for the damages claimed. The bottom portion is reserved for SCDOT use only, where claim numbers, approval status, and final amount determinations are recorded.