International Terrorism Victim Expense Reimbursement Program Application

Forms and Documents

Document Name	Status
International Terrorism Victim Expense Reimbursement Program Form	Modified
3DocSupportingStatement-Current June 2014. final.doc Supporting Statement A	2014-09-24
6DocTheLaw1-Current December 2009.doc Supplementary Document	2010-04-16

IC Document Collections

IC ID	Document Title	Status
192597	International Terrorism Victim Expense Reimbursement Program Form	Modified

ICR Details

OMB Control No: 1121-0309	ICR Reference No: 201409-1121-002
Status: Historical Active	Previous ICR Reference No: 201306-1121-003
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: 12/17/2014
	Date Received in OIRA: 09/24/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	36 Months From Approved	12/31/2014
Responses	100	0	100
Time Burden (Hours)	75	0	75
Cost Burden (Dollars)	300	0	300

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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:
	79 FR 37353	07/01/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 55014	09/15/2014
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
International Terrorism Victim Expense Reimbursement Program	none	ITVERP application

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ICR Summary 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	100	100	0	0	0	0
Annual Time Burden (Hours)	75	75	0	0	0	0
Annual Cost Burden (Dollars)	300	300	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $570

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]? No

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: 09/24/2014

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