Are there other ways to submit the Washington State Tort Claim? 080 requires citizens to present the Standard Tort Claim form with the County Auditor or to the Deputy Auditor.You must sign and date this official claim form. Before filing a Tort Claim, please read these instructions the Tort Claim form and other appropriate forms in their entirety. The FTCA Deemed Health Center Search Tool searches a listing of recipients of Health Center Program grant funding that have been deemed as PHS employees. This is an Official Bankruptcy Form. DALLAS, TEXAS 75201. 214-670-3120. Please complete both pages of this form. ✓ If you are filing a personal injury claim, please sign and attach the Medical Release. In other words, fill out an inmate request to staff member ("copout" form) and then follow the official grievance procedure beginning with a BP-9.