Government Claim Government ClaimOffice of Risk and Insurance ManagementGovernment Claims Program 2026

1. Begin by clicking ‘Get Form’ to open the Government Claim form in our editor.
2. Fill in the Claimant Information section, including your last name, first name, and contact details. If applicable, provide your inmate or patient identification number.
3. Indicate if you are under 18 years of age and whether this is an amendment to a previously existing claim. If so, include the existing claim number.
4. Complete the Attorney or Representative Information section if you have legal representation. Ensure all fields are filled accurately.
5. In the Claim Information section, specify the state agencies involved, date of incident, dollar amount of claim, and provide a detailed description of damages or injuries.
6. If applicable, complete the Automobile Claim Information section regarding state vehicles and insurance claims.
7. Finally, review all sections for completeness. Sign and date the form before submitting it along with any required documentation.

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