In order to complete your claim, you must complete all blocks of the attached Standard Form. (SF) 95, Claim For Damage, Injury, or Death.Find out about procedures and forms for filing a claim against Pierce County. 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. State shall be filled within 180 days after the action occurs. The Federal Tort Claims Act prescribes a uniform procedure for handling of claims against the United States, for money damages only. In the United States and its territories. Please carefully read all of the information in this packet before completing and presenting your. Washington State Tort Claim. Fill out the form or call us at 877.800.