Submit the completed Washington State Tort Claim form to the following fax number: 360-507-9251. The Claim for Damages and Authorization for Release of Medical Information Forms may be completed online below or you may download and print the forms.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. Are there other ways to submit the Washington State Tort Claim? Pursuant to Chapter 4.96 RCW, this form is for filing a tort claim against Snohomish County. One of the broadest waivers of sovereign immunity in the country. 100 requires citizens to present the Standard Tort Claim form with the Office of Risk. 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. Form Number, Form Name, Category. B 101, Voluntary Petition for Individuals Filing for Bankruptcy, Individual Debtors.
