BOP Program Statement 1320.07 § 3

(a) Claimant. You may file a claim if you are the injured person or the owner of the damaged or

lost property. A person acting on your behalf as an agent, executor, administrator, parent,

guardian, or other representative may file a claim for you if the person provides a written

statement signed by you giving that person permission to act for you. A representative may also

file a claim for wrongful death. If you hire a lawyer or authorize a representative to act on your

behalf, the agency will correspond only with that representative, and will not continue to

correspond with you.

A claim may be filed by any individual (e.g., inmate, employee, visitor, or private citizen). You

must file a claim within two years after your claim arises under 28 U.S.C. § 2401(b). Should a

settlement offer be made, the voucher will contain both your name and the name of your

representative, if applicable.

Regional Counsel employees track all claims that are filed properly within their regions.

Claims are closed after they are either settled, denied, rejected, or transferred to another agency

pursuant to 28 C.F.R. § 14.2.

Claims for damage to, or loss of, an inmate’s privately owned property is considered for

settlement under 31 U.S.C. § 3723. Please see Program Statement, Inmate Property Claims for

more information.

(b) Claim form. You may obtain a form from staff in the Central Office, Regional Offices,

Bureau institutions, or staff training centers.

Employees will provide a SF-95, Claim for Damage, Injury, or Death form, which is available on

the public U.S. General Services Administration (GSA) website in the GSA Forms Library and

on the Employee Resources page of the Bureau intranet.

A claim may be filed without a SF-95, Claim for Damage, Injury, or Death form. However, the

claimant should provide all the following information:

■ date of incident

■ place where the incident occurred

■ explanation of events

■ names of witnesses

■ description of injury or property loss

■ date of claim

■ sum certain claimed (required)

■ claimant’s signature (required)

Inmates should obtain forms from employees at the institution where they are incarcerated.

(c) Presenting a claim. You may either mail or deliver the claim to the regional office in the

region where the loss or injury occurred. If the loss or injury occurred in the Central Office, you

may either mail or deliver the claim to the Office of General Counsel, Central Office. A list of

addresses for all the Bureau institutions and offices can be found at www.bop.gov.

Institution employees will not accept claims submitted at institutions but will transfer the claims

to the correct Regional Office or the Central Office, depending on where the loss or injury

occurred.

If a claim is submitted to the Bureau in error, employees will forward it to the proper agency or

return it to the claimant if the agency cannot be identified. Please note, the term “agency”

includes executive departments, judicial and legislative branches, military departments, and

independent establishments of the United States.

Claims that are transferred to another agency will not be accepted or denied by the Bureau.