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Form A-472 (1 2-79) PROPERTY DAMAGE RELEASE AND REPORT RELEASE DAMAGE REPORT County Route Job No. (Day-Mo.-Yr.) 1. Date that property damage occurred Property Owners Name Owner's Mailing Address Location
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To fill out the Modot causes property damage form, start by obtaining the necessary form from the Modot website or their local office.
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Carefully read through the instructions provided with the form to ensure a complete and accurate submission. These instructions may include specific details on what information needs to be included, any supporting documentation that should be attached, and the deadline for submission.
03
Provide all the required information on the form, such as your personal details (name, address, contact information), the date and location of the incident that caused the property damage, and a detailed description of the damages incurred.
04
If available, include any supporting evidence such as photographs, videos, or witness statements that can help substantiate your claim.
05
Double-check all the information provided to ensure its accuracy and completeness. Incomplete or incorrect information may result in delays or rejection of your claim.
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Once the form is completed, submit it according to the instructions provided. This may involve mailing it to the appropriate Modot department or submitting it electronically through their website.
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Keep a copy of the filled-out form and any supporting documentation for your records.

Who needs Modot causes property damage?

01
Individuals who have experienced property damage as a result of an incident involving Modot, such as accidents involving their vehicles, road maintenance negligence, or property damage caused by construction activities.
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Property owners or landlords whose properties have been affected by Modot operations, such as landslides, flooding, or damage caused by heavy machinery.
03
Insurance companies or legal representatives who are assisting individuals with filing property damage claims against Modot on their behalf.
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Modot causes property damage refers to incidents or events where the Missouri Department of Transportation (MoDOT) is responsible for damage to private property due to road construction, maintenance, or other related activities.
Property owners whose property has been damaged by MoDOT activities are required to file a claim for property damage.
To fill out a MoDOT causes property damage claim, complete the appropriate claim form provided by MoDOT, include documentation of the damage, photographs, estimates, and any other relevant information that supports the claim.
The purpose of MoDOT causes property damage claims is to provide a process for property owners to seek compensation for damages incurred due to MoDOT operations, ensuring accountability and financial restitution.
Information that must be reported includes the date and location of the incident, a detailed description of the damage, estimates for repairs, and any evidence such as photographs or witness statements.
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Related Links

Transportation Safety - MO.gov
Safety is the Missouri Department of Transportation's (MoDOT) first priority. ... The accident caused property damage costing more than $500, or someone was ...

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Missouri A-472 AFE expl FUNC anatory fmed OBJ PROJ thereon Distri Comnlission TlON MHTD EGAL bution DIST undersigned Sel Yr arising PREFIX QUAN COMPLETING Org improvements Mailing

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