For USTIF to process your claim in timely manner, please follow these instructions.
- Complete all the fields highlighted in yellow.
- Save a copy for your records, once completed.
- 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.