Statement of Claim Related to Deportation from France During the Holocaust

Forms and Documents

Document Name	Status
Form DS-7713 Statement of Claim Related to Deportation from France During the Holocaust Form and Instruction	New
Holocaust Supporting Statement v2 (7-23-15).docx Supporting Statement A	2015-07-23
U.S.-France Agreement on Compensation for Certain Victims of Holocaust Deportation.pdf Supplementary Document	2015-06-30

IC Document Collections

IC ID	Document Title	Status
217292	Statement of Claim Related to Deportation from France During the Holocaust Form and Instruction	New

ICR Details

OMB Control No: 1405-0219	ICR Reference No: 201506-1405-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Statement of Claim Related to Deportation from France During the Holocaust
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/31/2015
	Date Received in OIRA: 06/30/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2018	36 Months From Approved
Responses	2,000	0	0
Time Burden (Hours)	6,000	0	0
Cost Burden (Dollars)	7,000	0	0

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Abstract: The information gathered will be used by the Department of State to evaluate claims from individuals harmed by deportation "from France towards a location outside of France during the Second World War as part of the anti-Semitic persecution carried out by the German Occupation authorities or the Vichy Government."

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Authorizing Statute(s): US Code: 22 USC 2651a; 2656; 2668a Name of Law: Disposition of Trust Funds Received from Foreign Governments for Citizens of the United States
  

Citations for New Statutory Requirements: None

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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:
	80 FR 22604	04/22/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 37352	06/30/2015
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Statement of Claim Related to Deportation from France During the Holocaust	DS-7713	Statement of Claim Related to Deportation from France During the Holocaust

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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	2,000	0	0	2,000	0	0
Annual Time Burden (Hours)	6,000	0	0	6,000	0	0
Annual Cost Burden (Dollars)	7,000	0	0	7,000	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: No

Burden Reduction Due to:

Short Statement: This is a new information Collection

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Annual Cost to Federal Government: $186,560

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: 06/30/2015

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