View Information Collection Request (ICR) Package

View ICR - Agency Submission

OMB Control No: 1123-0013	ICR Reference No: 202603-1123-001
Status: Received in OIRA	Previous ICR Reference No: 202601-1123-001
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: 03/12/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2026
Responses	700	700
Time Burden (Hours)	875	875
Cost Burden (Dollars)	0	0

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	, , , , , , , , ,

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

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