Application for Federally Supported Health Centers Assistance Act (FSHCAA) / Federal Tort Claims Act (FTCA) Particularized Determination of Coverage

OMB 0906-0077

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 FTCA Particularized Determination Application Form and Instruction
Particularized Determination Application Supporting Statement BPHC REV 1.docx Supporting Statement A
FTCA Particularized Determination Application Form and Instruction