Tort Claims

Legal Processes

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0046 can be found here:

Documents and Forms

Document Name Document Type
SF95.pdf Claim for Damage, Injury, or Death IC Document

Information Collection (IC) Details

IC Title:	Tort Claims	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 104.41-104.42

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	1	1

Documents for IC

Title	Document	Date Uploaded
Claim for Damage, Injury, or Death	SF95.pdf	05/08/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.