40A.09  Garda Compensation Personal Injuries Summons: Garda Síochána Compensation Act 2022

What this form is for

• • Use when a Garda wants to claim personal injury compensation under the 2022 Act.
• • Do not use for general civil claims unrelated to Garda service injuries.
• • If the injury occurred before the 2022 Act, a different legacy form may apply.
• • When the claim involves death or fatal injury, a separate death claim form is required.
• • For claims involving multiple incidents, each incident may need its own summons.

Use this form or another form?

Deadline or filing window

The summons should be filed within two years of the injury date, unless a court‑granted extension is obtained.

Before you submit

• • Garda's full name and service number entered correctly
• • Accurate date and location of the incident recorded
• • Clear description of the injury and medical diagnosis
• • Compensation amount calculated according to the 2022 Act
• • All required medical reports attached
• • Signature of the Garda (or authorized representative) present
• • Date of signing filled in
• • Correct court jurisdiction identified
• • Cover letter included (if required)
• • Copies of all attachments kept for personal records

How to file this form

1. 1Prepare all supporting medical and service documents.
2. 2Complete Form 40A.09 using printed or electronic version.
3. 3Attach the supporting documents in the order specified.
4. 4Sign and date the form.
5. 5Deliver the package to the appropriate District or Circuit Court in person or by post.
6. 6If using e‑filing, upload the PDF to the Courts Service portal and confirm receipt.
7. 7Obtain and keep the court's filing receipt or acknowledgment.

Known limitations

• • Form only applies to injuries occurring after the 2022 Act came into force.
• • Does not cover claims for psychological injury without a physical component unless medically documented.
• • Limited to personal injury; property damage or third‑party claims require separate forms.
• • No online payment of fees is possible through the form itself; fees are paid at the court.