Submit the completed Washington State Tort Claim form to the following fax number: 360-507-9251. Are there other ways to submit the Washington State Tort Claim?Instructions: (1) Complete this form giving specific details about your damage or loss. Submit to Appropriate Federal Agency: 2. Name, address of claimant, and claimant's personal representative if any. COMPLETING THE STANDARD FORM 95: The attached instructions are provided to assist you in correctly filling out the Standard Form 95. Before filing a Tort Claim, please read these instructions the Tort Claim form and other appropriate forms in their entirety. We value your privacy. Forprofit organization and world's largest provider of arbitration, mediation and other alternative dispute resolution (ADR) services. Application to do business in the state of Texas for PrimeOne Insurance.