The TSA adjudicates tort claims under
the authority of the Federal Tort Claims Act (FTCA) (28 U.S.C. §§
1346(b), 1402(b), 2401(b), 2671-2680). To thoroughly examine tort
claims against the agency, TSA needs to collect additional
information from claimants. The respondents to this collection are
typically the traveling public, but may include others who have
contact with TSA operations at various locations. Submission of a
claim is entirely voluntary and initiated by individuals. Claimants
typically file a claim by submitting to TSA a Standard Form 95
(SF-95), Claim for Damage, Injury, or Death, a form prescribed by
the Department of Justice and approved under OMB control number
1105-0008. Because TSA requires further clarifying information in
order to thoroughly examine their claim, claimants are asked to
complete a Supplemental Information page added to the SF-95. For
example, the Supplemental Information identifies the airport at
which the incident occurred and states, if applicable, whether the
incident occurred at a passenger security screening checkpoint or a
checked baggage screening location. If the claim involves checked
baggage, the Supplemental Information page identifies whether any
third parties handled the checked bag and whether a checked bag was
delayed. This information enables the claims examiner to promptly
initiate a thorough investigation into the alleged loss and
significantly reduces the time required to process the claim. This
information also assists with identifying whether the claim should
be more appropriately processed under the Military Personnel and
Civilian Employees’ Claims Act (MPCECA).
The respondents to the
collection have decreased since the previous OMB approval. As a
result, the burden has decreased. TSA adding TSA Form 600 to the
collection does not impact the burden as the change to the burden
is de minimis.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Form SF 95 Filing a Claim
31 USC 33259(d).pdf
1652-0039 TSAClaimsApp SS.docx
Filing a Claim