Filing Claims Under the Federal Tort Claims Act

OMB 0960-0667

OMB 0960-0667

SSA uses the information provided to investigate and determine whether to make an award, compromise, or settlement under the Federal Tort Claims Act (FTCA). The information is only used by those Agency employees who need the information in the scope of their official duties. The respondents are individuals/entities making a claim under the FTCA.

The latest form for Filing Claims Under the Federal Tort Claims Act expires 2021-06-30 and can be found here.

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20 CFR 429.102; 429.103

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