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COMMENT
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OMB Control No:
1123-0013
ICR Reference No:
202601-1123-001
Status:
Received in OIRA
Previous ICR Reference No:
202304-1123-001
Agency/Subagency:
DOJ/CD
Agency Tracking No:
1123-0013
Title:
United States Victims of State Sponsored Terrorism Fund Application
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
Date Submitted to OIRA:
01/23/2026
Requested
Previously Approved
Expiration Date
36 Months From Approved
02/28/2026
Responses
700
700
Time Burden (Hours)
875
875
Cost Burden (Dollars)
0
0
Abstract:
The United States Victims of State Sponsored Terrorism Fund (Fund) provides compensation to certain individuals who were injured as a result of an international act of terrorism by a state sponsor of terrorism. The Justice for United Victims of State Sponsored Terrorism Act sets forth criteria for eligibility under the Fund, such as a final judgment issued against a state sponsor of terrorism. The Fund Application Form requests information to determine eligibility and amount of compensation.
Authorizing Statute(s):
US Code:
42 USC 10609
Name of Law: Justice for United States Victims of State Sponsored Terrorism Act
Citations for New Statutory Requirements:
US Code: 42 USC 10609(b)(2)(B) Name of Law: Justice for United States Victims of State Sponsored Terrorism Act
US Code: 42 USC 10609(c)(3)(A) Name of Law: Justice for United States Victims of State Sponsored Terrorism Act
US Code: 42 USC 10609(d)(2) Name of Law: Justice for United States Victims of State Sponsored Terrorism Act
US Code: 42 USC 10609(b)(4)(A) Name of Law: Justice for United States Victims of State Sponsored Terrorism Act
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
90 FR 53390
11/25/2025
30-day Notice:
Federal Register Citation:
Citation Date:
91 FR 2967
01/23/2026
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
USVSST Application
Notice of Filing Claim, OMB #1123-0013, OMB #1123-0013, OMB #1123-0013, OMB #1123-0013, OMB #1123-0013, OMB #1123-0013, OMB #1123-0013, OMB #1123-0013, OMB #1123-0013
USVSST Notice of Claim
,
USVSST Fund Application Form
,
USVSST Change of Attorney Form
,
USVSST Application's Acknowledgement of Statutory Limitation on Attorneys' Fees
,
UVSST Attorney's Fee Certification
,
USVSST Authorization for Communication
,
USVSST Hearing Request Form
,
USVSST informer Information and Acknowledgement
,
USVSST Direct Deposit Form
,
USVSST Certification of Personal Representative
ICR Summary of Burden
Total Request
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
700
700
0
0
0
0
Annual Time Burden (Hours)
875
875
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
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.
Yes
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:
Jennifer Bickford 202 514-1470
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
01/23/2026
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