Submit the completed Washington State Tort Claim form to the following fax number: 360-507-9251. The Federal Tort Claims Act prescribes a uniform procedure for handling of claims against the United States, for money damages only.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. 19. Please attach documents which support the allegations of the claim. 20. 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. The OGC will provide a potential claimant with a claim form and inform him as to the required documentation. The Tort Claims Section will review and assess the Commonwealth's liability for any alleged property damage and will offer settlement. NOTE: This form is required for all FTCA and MCA claims when the. Fill out the claim form completely (front and back). Instructions for completing the Standard Washington State Tort Claim Form.
