Standard Form 95 is used to present claims against the United States under the Federal Tort Claims Act (FTCA) for property damage, personal injury, or death. A claim predicated on a negligent or wrongful act of EPA or its employees may be filed using Standard Form 95.STANDARD FORM 95 (SF 95), "Claim for Damage, Injury, or Death": You must submit three. (3) completed forms, WITH AN ORIGINAL SIGNATURE, IN INK, ON EACH COPY. The Federal Tort Claims Act prescribes a uniform procedure for handling of claims against the United States, for money damages only. An Overview Of Standard Form 95. Use Standard Form 95 (PDF)(2 pp, 539 K) to file claims for loss of employment, loss of income, loss or damage to property, or other claims. Claimants who wish to file an administrative tort claim against CBP should complete a Standard Form 95, Claim for Damage, Injury, or Death and submit it.
