Claim for Damage Injury or Death

Claim for Damage Injury or Death

OMB: 1105-0008

IC ID: 11731

Information Collection (IC) Details

View Information Collection (IC)

Claim for Damage Injury or Death
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CIV-SF-95 Claim for Damage, Injury, or Death SF-95 11 17 2006.pdf http://www.usdoj.gov/civil/forms/forms.htm No   Fillable Printable

Litigation and Judicial Activities Legal Investigation

 

100,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 100,000 0 0 -300,000 0 400,000
Annual IC Time Burden (Hours) 600,000 0 0 -1,800,000 0 2,400,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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