View Information Collection Request (ICR) Package

View ICR - Agency Submission

Comment Period Closed - Comments are accepted for the first 30 days of OIRA's review. See FAQ page for more information.

OMB Control No: 1105-0008	ICR Reference No: 202601-1105-001
Status: Received in OIRA	Previous ICR Reference No: 202109-1105-001
Agency/Subagency: DOJ/LA	Agency Tracking No: CIV-2008-1
Title: Claim for Damage Injury or Death
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 01/16/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	100,000	0
Time Burden (Hours)	600,000	0
Cost Burden (Dollars)	0	0

Annual Cost to Federal Government: $603,750

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Jason Bougere 202 307-2737

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.