Claims of U.S. Nationals Referred to the Commission by the Department of State Pursuant to the International Claims Settlement Act of 1949, as Amended

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0100 can be found here:

Documents and Forms

Document Name Document Type
Form XXXX Claims of U.S. Nationals Referred to the Commission by the Department of State Pursuant to the International Claims Settlement Act of 1949, as Amended Form and Instruction
XXXX Statement of Claim Referral Claim Form v2 Corp_091013.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Claims of U.S. Nationals Referred to the Commission by the Department of State Pursuant to the International Claims Settlement Act of 1949, as Amended	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	XXXX	Statement of Claim	Referral Claim Form v2 Corp_091013.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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