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Standard Form 95: Claim for Damage, Injury, or Death - Page 1
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Standard Form 95: Claim for Damage, Injury, or Death

Used to file a claim under the Federal Tort Claims Act against a federal agency for property damage, personal injury or death caused by a federal employee.

Current Version
Source: U.S. Department of Justice / General Services Administration

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Instructions for filling out Standard Form 95: Claim for Damage, Injury, or Death

This template is used for official filing and documentation. Below are detailed instructions for completing, requirement details, and submission rules.

Who needs to fill out this document?

This form is designed for use by legal entities, individuals, or authorized representatives in the following cases:

  • People injured by a federal employee or vehicle.
  • Property owners with damage caused by a federal agency.
  • Attorneys filing FTCA claims.

What you will need before starting

Before filling out the interactive form, prepare the following details and documents:

1. Incident detailsDate, place and description of the incident.
2. Amount claimedA specific dollar amount for damage and injury.
3. EvidenceRepair estimates, medical bills and witness information.
4. Insurance informationYour insurance coverage for the loss.

Step-by-step filling process

  1. Address to the agency: Send to the federal agency involved.
  2. Describe the incident: Basis of the claim and damage.
  3. State a sum certain: Claims without a specific amount may be invalid.
  4. File within 2 years: Within 2 years of the incident.

Frequently Asked Questions (FAQ)

Why must I state a dollar amount?

A 'sum certain' is required for a valid claim and generally limits what you can recover later.

Can I sue right away?

No. You must file an administrative claim first and wait for denial or 6 months.

Is SF-95 the only way to file?

Any written notice with the required information works, but SF-95 is standard.

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