Department of Legal Affairs, Taipei City Governmen

The claim form should include the following information and be signed or sealed by the claimant or agent before submitting it to the compensating authority.

1. The claimant’s name, sex, birth date, birth place, identification number, occupation, and current address or permanent address. If the claimant is a corporate body or group, its name and major office or major business office, as well as the name, sex, current address or permanent address of the representative of the corporate or group.
2. If there is an agent, the name, sex, birth date, birth place, identification number, occupation, current address or permanent address of the agent.
3. Relevant details and the reason for claiming for state compensation.
4. The total amount of compensation for damage claimed for or the details for the restoration of the damage.
5. The compensating authority.