Voucher, schedule and claim numbers
Voucher No., Schedule No. and Claim No. at the top right, with a Paid By box below them.
SF1145
Voucher for Payment Under Federal Tort Claims Act
- Agency
- GSA
- Revision
- Revised January 1992
- Fillable fields
- 34
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
Standard Form 1145 (SF 1145): Voucher for Payment Under Federal Tort Claims Act
Standard Form 1145 (SF 1145), Voucher for Payment Under Federal Tort Claims Act, is a Department of the Treasury form, printed as Standard Form 1145 (EG), Revised 1/92, with the reference 1 TFM 4-2000. GSA hosts a copy in its forms library.
The voucher records a payment by the United States on a claim under the Federal Tort Claims Act: the department, bureau or establishment, the payee and address, the amount claimed, the date the claim accrued, and the amount of award, compromise, or settlement. It then carries three signature blocks: the claimants' acceptance, approval by the head of the Federal agency or an authorized designee under 28 U.S.C. 2673, and certification by an authorized certifying officer. Each block is marked SIGN ORIGINAL ONLY.
You can fill it out free in your browser on this page and download the result without an account.
What's on SF 1145
Agency and payee
The U.S. department, bureau, or establishment, the place and date the voucher was prepared, and the payee(s) with their address.
Amounts and description
Amount claimed, the date the claim accrued, the amount of award, compromise, or settlement, and a brief description of the claim, with attachments for further detail.
Acceptance by claimant(s)
Printed text in which the claimant(s) and beneficiaries accept the award, compromise, or settlement as final and conclusive, with a date and two claimant signature lines.
Approval and certification
Approval by the head of the Federal agency or authorized designee, and the certifying officer's certification that the voucher is correct and proper for payment, each with an amount, date and title.
Accounting classification and payment
An accounting classification block and a Paid by Check No. line at the bottom.
How to complete SF 1145
- 1
Enter the voucher details
Fill in the voucher, schedule and claim numbers, the department, bureau or establishment, and the place and date the voucher was prepared.
- 2
Name the payee
Enter the payee(s) after The United States, Dr., To, and their address.
- 3
Enter the amounts and description
Enter the amount claimed, the date the claim accrued, the amount of award, compromise, or settlement, and a brief description of the claim.
- 4
Claimant acceptance
The claimant(s) sign and date the Acceptance by Claimant(s) block. The form says to sign the original only.
- 5
Approval and certification
The head of the Federal agency or authorized designee signs the approval, and an authorized certifying officer signs the certification, each with the amount, date and title.
- 6
Accounting and payment
Complete the accounting classification. The Paid By box and the Paid by Check No. line record how the voucher was paid.
Why fill Form SF1145 on indox
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Where it goes and what the form says
Where it goes
The PDF prints no address or routing instructions. It is a payment voucher with a Paid By box and a Paid by Check No. line.
Statute named on the form
The approval block says the claim has been fully examined in accordance with the provisions of the Federal Tort Claims Act (28 U.S.C. 2673).
Release in the acceptance
The form's acceptance text says it constitutes a complete release of claims against the United States and the Government employee(s) arising from the same subject matter, and includes an agreement to reimburse, indemnify, and hold harmless the United States.
Signatures
The claimant, approval and certification blocks are each marked SIGN ORIGINAL ONLY.
What the PDF does not print
No OMB number, Privacy Act statement or instructions. GSA's page lists no authority or regulation.
Related forms
Who signs SF 1145?
The form does not say who prepares the voucher. It names the department, bureau or establishment and the place and date it was prepared, and it has these blocks.
Official sources and the blank
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Questions about Form SF1145
Who issues SF 1145?
The form is printed as Standard Form 1145 (EG), Revised 1/92, Department of the Treasury, 1 TFM 4-2000. GSA hosts a copy in its forms library.
What is SF 1145 used for?
It is titled Voucher for Payment Under Federal Tort Claims Act. It records the payee, the amount claimed, the date the claim accrued and the amount of award, compromise, or settlement to be paid.
Who signs SF 1145?
The claimant(s) sign the acceptance, the head of the Federal agency or an authorized designee signs the approval, and an authorized certifying officer signs the certification. Each block is marked SIGN ORIGINAL ONLY.
What does the claimant acceptance say?
It says the claimant(s) and beneficiaries accept the award, compromise, or settlement as final and conclusive, and that the acceptance constitutes a complete release of claims arising from the same subject matter against the United States and the Government employee(s) involved.
Which law does the form cite?
The approval block cites the Federal Tort Claims Act (28 U.S.C. 2673). The header cites 1 TFM 4-2000.
Where is SF 1145 sent?
The PDF prints no address. It names the department, bureau or establishment and the place the voucher was prepared.