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Federal forms, ICRs, and supporting documents

OMB control number

Filing Claims Under the Federal Tort Claims Act

OMB 0960-0667 · SSA.

OMB 0960-0667

The Federal Tort Claims Act (FTCA) is the mechanism for compensating people who Federal employees injured through negligent or wrongful acts that occurred during the performance of those employees’ official duties. SSA accepts claims filed under the FTCA for damages against the United States; loss of property; personal injury; or death resulting from an SSA employee’s wrongful act or omission. The various types of claims included under this information collection request require claimants to provide information SSA can use to determine whether to make an award, compromise, or settlement under the FTCA. The respondents are individuals or entities making a claim under the FTCA.

The latest form for Filing Claims Under the Federal Tort Claims Act expires 2027-09-30 and can be found here.

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OMB Details

20 CFR 429.102; 429.103 - Filing a Claim (SF-95, OMB No. 1105-0008)

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form SF-95Claim for Damage, Injury, or Deathwww.gsa.gov/reference/forms/claim-for-damage-injury-or-deathForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.