International Terrorism Victim Expense Reimbursement Program Application

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
International Terrorism Victim Expense Reimbursement Program	Form	New	Available
6DocTheLaw1-Current December 2009.doc	Supplementary Document	Uploaded 2010-04-16	Available
3DocSupportingStatement-Current December 2009.doc	Supporting Statement A	Uploaded 2010-04-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192597	International Terrorism Victim Expense Reimbursement Program	Form	New
12629	International Terrorism Victim Expense Reimbursement Program Application	Instruction	Removed

ICR Details

OMB Control No: 1121-0309	ICR Reference No: 201003-1121-002
Status: Historical Active	Previous ICR Reference No: 200702-1121-001
Agency/Subagency: DOJ/OJP	Agency Tracking No: OVC
Title: International Terrorism Victim Expense Reimbursement Program Application
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/28/2010
	Date Received in OIRA: 04/19/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2013	36 Months From Approved	05/31/2010
Responses	2,000	0	2,000
Time Burden (Hours)	1,500	0	1,500
Cost Burden (Dollars)	6,000	0	6,000

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Abstract: The application is nesssary for victims/claimants to request reimbursement of funds. Collection of information is necessary to assist OVC staff to objectively, fairly, and equitably determine distribution of reimbursement of funds and account for allocation of funds. Respondent will include U.S. government employees and U.S. Nationals who become victims of international terrorism that occurs outside of the U.S.

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Authorizing Statute(s): US Code: 42 USC 10603c Name of Law: Victims of Crime Act of 1984
  

Citations for New Statutory Requirements: US Code: 42 USC 10603c Name of Law: Victims of Crime Act of 1984

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 3758	01/22/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 14184	03/24/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
International Terrorism Victim Expense Reimbursement Program	None	International Terrorism Victim Expense Reimbursement Program
International Terrorism Victim Expense Reimbursement Program Application	None	International Terrorism Victim Expense Reimbursement Program Application

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	2,000	2,000	0	0	0	0
Annual Time Burden (Hours)	1,500	1,500	0	0	0	0
Annual Cost Burden (Dollars)	6,000	6,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There is no change in the burden. This is an extension without change of an currently approved collection.

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Annual Cost to Federal Government: $21,849

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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]? Uncollected

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

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 04/19/2010

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