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The State Administrative Board (Ad Board) has the authority to consider, determine, and allow claims against the State of Michigan, its departments, officers, and colleges and universities for the loss of personal property or for personal injury in amounts less than $1000.00.
Who can file
- General public (citizens)
- State employees (with certain limits)
- Current or former prisoners
- Individuals whose claim was denied by the Michigan Department of Transportation
Claim limits
- $1000.00 or more:
File with the Michigan Court of Claims. Or, as an option, file a $999.99 or less claim with the Ad Board. - $500.00 or less (state employees):
May be resolved internally by the department. Exceptions include eyeglasses, jewelry over $50.00, cash over $100.00, and personal vehicle claims.
Value determination
- Reimbursement is based on present value, not replacement cost. The present value is calculated with a 20% straight-line depreciation rate per year starting with year two and continuing until a residual balance of 10% remains.
- If an original receipt is not available, the residual balance may be calculated using the current average cost.
- Automobiles, eyeglasses, precious metal jewelry, and cash are not depreciated.
Claim forms
Contact info
Email:
DTMB-StateAdBoard@michigan.gov
Phone:
517-657-1786
State Ad Board Mailing Address
State Administrative Board
PO Box 30026
Lansing MI 48909-7526
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Civilian claims
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Claims denied by MDOT
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State employee claims
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Prisoner claims
How to file a claim against the State of Michigan:
To start a claim against the State of Michigan, you'll need to fill out and submit a DTMB-1104 Claim Form and include documents that support your claim.
- Print and complete the DTMB-1104 Claim Form.
Follow the instructions on page 2. - Sign the form before a notary.
This is required. - Submit your notarized claim form and supporting documents.
You can submit your claim by email or by mail.
What supporting documentation should I include?
Include the following items to support your claim. Do not send originals, send copies. Original documents will not be returned.
- Original Receipt(s)
- Repair or replacement estimate(s)
- Police Report
- Incident Report
- Proof of insurance deductible
- Proof of out-of-pocket costs
Where can I find more information?
You can find more information regarding Claims Against the State by the General Public and the claims process in the Administrative Guide: 0620.08 Submission of Claims by the General Public
My claim was denied by MDOT. Can I file my claim with the Ad Board?
Yes, if your claim is $999.99 or less. Here’s what to do:
- Contact the Ad Board Claims Analyst
You may contact the Claims Analyst by email or by phone.
Email: DTMB-StateAdBoard@michigan.gov
Phone: 517-657-1786
What will I need to provide?
The Claims Analyst will need your full name and the name of the person who signed the MDOT denial letter. We’ll request your claim packet from the MDOT Transportation Center that denied your claim and can use the same claim form and supporting documents to file your claim with the Ad Board.
NOTE: If your MDOT-3600 Claim Form was not notarized, we will return it to you for notarization.
Where can I find more information?
You can find more information regarding Claims Against the State by the General Public and the claims process in the Administrative Guide: 0620.08 Submission of Claims by the General Public
How do I file a claim against the State as a state employee?
NOTE: Your department director may choose to resolve your claim if it is less than $500.00, except for claims than involve eyeglasses, jewelry, cash, or personal vehicle.
To start a claim against the State of Michigan, complete and submit a DTMB-1104 Claim Form and include documents to support your claim.
- Print and complete the DTMB-1104 Claim Form.
Follow the instructions on page 2. - Sign the form before a notary.
This is required. - Send the Claim Form and copies of any supporting documentation to us.
You can send the claim by email or by mail.
What supporting documentation should I include?
Include the following items to support your claim. Do not send originals, send copies. Original documents will not be returned.
- Original Receipt(s)
- Repair or replacement estimate(s)
- Police Report
- Incident Report
- Proof of insurance deductible
- Proof of out-of-pocket costs
NOTE: Claims for reimbursement for eyeglass repair or replacement must include a receipt or estimate for the replacement cost after insurance is applied.
Where can I find more information?
You can find more information regarding Claims Against the State by State Employees and the claims process in the Administrative Guide: 0620.07 Submission of Claims by State Employees to the Finance and Claims Committee
How do current and former Michigan Department of Corrections (MDOC) prisoners file claims?
- Print and complete the DTMB-1104-P Claim Form or request a Claim Form from the Grievance Coordinator or designee at the correctional facility where incarcerated.
Follow the instructions on page 2. Do not alter the claim form. - Sign the Claim Form before a notary.
This is required. - Submit the Claim Form to the Grievance Coordinator or designee at your facility per MDOC policy and procedures.
Include copies of the documentation to support your claim.
What supporting documentation should I include?
Include the following items to support your claim. Do not send originals, send copies. Original documents will not be returned.
- Proof of Purchase/Receipt(s)
- Pack or Unpack documentation
- Any documentation verifying possession and ownership
You can find more information regarding Claims Against the State by MDOC Prisoners and the claims process in the Administrative Guide: Administrative Guide 0620.0