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Fillable AcroFormUnited States

US Standard Form 95 Claim for Damage Injury or Death (Rev. 2-2007)

Fillable PDF form with 39 form fields over 2 pages. Category: Legal, Justice & Courts › General.

FormatPDF (AcroForm)
Pages2
Form fields39 fillable fields
JurisdictionUnited States
Field / typeLegal, Justice & Courts › General
Version (last updated)2026-10-17
LicenceUS-gov-PD (checked 2026-10-17)
AttributionSource: Standard Form 95 (Rev. 2/2007), U.S. Department of Justice / GSA Forms Library (public domain in the United States, 17 U.S.C. 105; official form available free at gsa.gov). Prepared by FormSphere as a fillable AcroForm; not affiliated with or endorsed by any U.S. government agency.
Please check this template for currency and for your local requirements before using it. It is a blank template, not legal advice and not a guarantee of compliance.

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