For USTIF to process your claim in timely manner, please follow these instructions.

1. Please fill out the fields highlighted in yellow
2. After completing the form, hit the (Save and Submit) button.
3. A (Save As) window will appear, please retain a copy for your records.
4. An email will open with form attached with the correct subject line. Please click (Send) and USTIF will receive your request.
5. If the (Save and Submit) is not working, please email the form to RA-IN-FBSCLAIMS@PA.GOV with the subject line:
   CLAIM NOTIFICATION SUBMITTAL FORM

If you run into issues, please contact by calling 717-783-8093 and follow the prompts for Claims Department. Thank you.