Information Collection

Claims of United States Nationals Against Iraq

IC 205302 under ICR 201301-1105-001 · OMB 1105-0098.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Iraq - Referral from State_010913.pdf	Other-Referral
Iraq - Settlement Agreement_010913.pdf	Other-Agreement
Iraq - Instructions - v 4- for completeing Statement of Claim under First LIraq Referral_010913.doc	Instruction
FCSC Form 1-12 Statement of Claim Iraq - November 2012 v 3 Referral Claim Form_010913.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Referral			Iraq - Referral from State_010913.pdf	Yes	Yes	Paper Only
Other-Agreement			Iraq - Settlement Agreement_010913.pdf	Yes	Yes	Paper Only
Form	FCSC Form 1-12	Statement of Claim	Iraq - November 2012 v 3 Referral Claim Form_010913.pdf	Yes	Yes	Fillable Printable
Instruction			Iraq - Instructions - v 4- for completeing Statement of Claim under First LIraq Referral_010913.doc	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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