California Code, Health and Safety Code - HSC § 80925

(1) A provision requiring the claimant to make a sworn verification of the claim to the best of the claimant's knowledge.

(2) A full description, supported by appropriate evidence from government agencies of the release of the hazardous substance claimed to be the cause of the physical injury or illness or loss of income.

(3) Certification by the claimant of dates and places of residence for the five years preceding the date of the claim.

(4) Certification of the medical history of the claimant for the five years preceding the date of the claim, along with certification of the alleged physical injury or illness and expenses for the physical injury or illness. The certification shall be made by hospitals, physicians, or other qualified medical authorities.

(5) The claimant's income as reported on the claimant's federal income tax return for the preceding three years in order to compute lost wages or income.