DA Form 7500: Tort Claim Payment Report PDF Download – If you work in U.S. Army claims processing, finance, or Judge Advocate General (JAG) offices, you’ve likely encountered DA Form 7500, officially titled the Tort Claim Payment Report. This essential Army form documents and reports payments for tort claim settlements and judgments against the United States. It ensures accurate financial tracking and compliance with federal claims regulations.
Whether you’re an Army claims attorney, certifying officer, or DFAS processor, this guide covers everything you need to know about DA Form 7500, including its purpose, when to use it, how to complete it step-by-step, and the official fillable PDF download.
What Is DA Form 7500?
DA Form 7500 is a standardized U.S. Department of the Army form released in June 2003 (DA FORM 7500, JUN 2003). It serves as the official Tort Claim Payment Report for all tort claims paid under Army authority.
- Proponent agency: Office of The Judge Advocate General (OTJAG).
- Prescribed by: DA PAM 27-162 (Claims Procedures) and AR 27-20 (Claims).
- Key note on the form: “A SEPARATE PAYMENT REPORT MUST BE COMPLETED FOR EACH CLAIMANT.”
This is not the form civilians or service members use to file a tort claim (that’s Standard Form 95). DA Form 7500 is strictly an internal payment and reporting document used after a claim is settled or a judgment is paid.
Purpose of the Tort Claim Payment Report
The primary purpose of DA Form 7500 is to:
- Report payments made as settlements, compromises, or judgments in tort claims against the U.S. Army.
- Provide DFAS (Defense Finance and Accounting Service) with complete payment data, including EFT (Electronic Funds Transfer) details when applicable.
- Capture the claimant’s formal acceptance and full release of all claims.
- Obtain certification from an authorized Army certifying officer that the payment is proper.
It supports claims processed under multiple authorities, including:
- Federal Tort Claims Act (FTCA)
- Military Claims Act (MCA)
- Other statutes handled by Army claims offices worldwide
Accurate completion ensures prompt payment, proper fund citation, and audit compliance.
Who Uses DA Form 7500?
- U.S. Army Area Claims Offices (ACOs) and Claims Processing Offices (CPOs)
- Judge Advocate General (JAG) claims personnel
- USARCS (U.S. Army Claims Service)
- Finance and accounting officers who submit to DFAS
- Certifying officials authorized to approve tort claim payments
Important: DA Form 7500 is used alongside its counterpart, DA Form 7501 (Personnel Claim Payment Report), but the two forms are never interchangeable.
Step-by-Step: How to Fill Out DA Form 7500?
Here is the exact layout and required fields from the official form (direct from the June 2003 version still in use):
Header Information
- 1. TO: DFAS, DSSN
- 2. DATE (YYYYMMDD)
- 3. SUBMITTING AGENCY/OFFICE
- 4. OFFICE CODE
- 5. AGENCY/OFFICE MAILING ADDRESS
- 6. DATE CLAIM FILED (YYYYMMDD)
- 7. CLAIM NUMBER(S)
- 8. AMOUNT CLAIMED
- 9. FUND CITE
- 10. PAYEE
- 11. ADDRESS
- 12. SSN OR TAX IDENTIFICATION NUMBER
- 13. PAYMENT AMOUNT
- 14. TYPE OF PAYMENT
SECTION A – PAYMENT DATA (For EFT Payments)
- 15. ABA ROUTING NUMBER
- 16. ACCOUNT NAME AND NUMBER
- 17. NAME AND ADDRESS OF FINANCIAL INSTITUTION
- 18. ACCOUNT TYPE (Checking or Savings – check the box)
SECTION B – ACCEPTANCE BY CLAIMANT
This section contains the full legal release language. The claimant must sign and date unless a separate release form is already attached. The release is broad and covers all known and unknown claims arising from the incident.
- 19. SIGNATURE OF CLAIMANT
- 20. DATE (YYYYMMDD)
SECTION C – AGENCY CERTIFYING OFFICER
- 21. SIGNATURE OF AUTHORIZED CERTIFYING OFFICER
- 22. DATE (YYYYMMDD)
- 23. TITLE
- 24. DATE PAYMENT RECORDED IN CLAIM RECORD (YYYYMMDD)
Certification statement: “Pursuant to authority vested in me, I certify that this Payment Report is correct and proper for payment.”
Official DA Form 7500 PDF Download
✅ Download the latest fillable DA Form 7500 directly from the U.S. Army Publishing Directorate:
The form is fillable online or printable. Always use the official source to ensure you have the most current version.
Related Army Claims Resources
- AR 27-20 – Claims (8 February 2008)
- DA PAM 27-162 – Claims Procedures (21 March 2008)
- Standard Form 95 – Claim for Damage, Injury, or Death (used to file the original claim)
- U.S. Army Claims Service (USARCS) guidance via JAGCNet
These publications provide full procedural guidance on tort claim adjudication and payment.
Frequently Asked Questions (FAQs)
Q: Is DA Form 7500 still current in 2026?
A: Yes. The JUN 2003 version remains the official form prescribed by current Army claims policy.
Q: Can claimants download and fill this out themselves?
A: No. This is an internal Army payment report completed by claims and finance personnel after settlement.
Q: What’s the difference between DA Form 7500 and DA Form 7501?
A: DA 7500 is for tort claims; DA 7501 is for personnel claims (e.g., personal property damage under the Personnel Claims Act).
Q: Where do I send the completed DA Form 7500?
A: Submit to DFAS with the appropriate DSSN as indicated in Block 1.
DA Form 7500 is a critical tool in the U.S. Army’s tort claims program that ensures transparent, auditable, and legally sound payment of settlements and judgments. Proper use protects both the government and the claimant while maintaining compliance with federal law and Army regulations.
For official processing, always reference the most recent AR 27-20 and DA PAM 27-162 through official JAG or USARCS channels.
Need the form right now?
Click here to download the official DA Form 7500 Tort Claim Payment Report PDF