1105-0100 SS Part A_081816

DEPARTMENT OF JUSTICE

FOREIGN CLAIMS SETTLEMENT COMMISSION OF THE UNITED STATES

SUPPORTING STATEMENT FOR
REQUEST FOR OMB APPROVAL OF COLLECTION OF INFORMATION
UNDER THE PAPERWORK REDUCTION ACT AND 5 CFR 1320

Claims of United States Nationals

OMB Number 1105-0100

FCSC 1

A. Justification

1. This collection of information is needed in order to enable the Foreign Claims Settlement Commission to receive, examine and adjudicate claims of U.S. nationals made pursuant to the terms of referrals of classes of claims to the Commission by the Department of State under 22 U.S.C. 1623(a)(1)(C). The Commission is authorized, under 22 U.S.C. §1623 (Attachment A), to receive, examine and adjudicate claims of U.S. nationals.

2. The collected information will be used by the Commission as the basis for determining the validity and amount of claims of U.S. nationals referred by the Department of State, and to certify awards resulting from those determinations to the Secretary of the Treasury for payment out of compensation funds provided for this purpose, in accordance with 22 U.S.C. §§1624-1627.

3. The Commission has developed this form to enable claimants or their legal representatives to enter the data electronically so as to facilitate efficient processing of the claims.

4. The Commission is unaware of any available sources that would contain information similar to that being requested.

5. This item is not applicable. To the Commission's knowledge, there are no small businesses or other small entities included among the claimants.

6. If the collection is not conducted, the Commission will be unable to review claims referred by the Department of State and ensure that meritorious claims are compensated.

7. There are no special circumstances associated with this collection.

8. A Federal Register notice has been published to solicit public comment.

9. This item is not applicable.

10. As reflected on the draft Statement of Claim form, the information submitted by the respondents will be subject to public disclosure under the Freedom of Information Act (5 U.S.C. § 552).

11. Depending on the claim filed, it may be necessary for the Commission to ask questions of a sensitive nature. The information will be used to adjudicate the claimants’ claims. The claimants will be provided the claim form, which will make clear that the information requested will be used to adjudicate the claim.

12. Annualized costs of this collection for the respondents will consist merely of postage and photocopying expenses, which should amount to less than $10 per respondent, and expenditure of their personal time in providing the information requested. As indicated on the attached Standard Form 83-I, it is estimated that there will be approximately 500 respondents, and that the one-time response will require an average of about two hours of each respondent's time. This estimate is derived based upon experience in past claims programs where similar types of information were collected. Using 500 respondents as a baseline, we project the total burden to be approximately 1,000 hours.

13. The Commission may ask claimants to provide a medical assessment, although it will likely rely primarily on evaluations conducted at the time of the injury. The Commission estimates that this expense should be less than $500 per claimant on average. This estimate is derived based upon experience in past claims programs where similar types of information was collected. Using 500 respondents as a baseline, if the Commission was to ask each claimant for a new medical evaluation, we project the total burden to be approximately $250,000.

14. There is no additional cost to the federal government for this collection.

15. Burden number changes are due to this being a new collection.

16. The information from this collection will form the basis for decisions of the Commission. The final decisions of the Commission will be published on the Commission’s public website pursuant to 5 U.S.C. § 552(a)(2) in due course.

17. This item is not applicable, as the OMB Approval Number will be displayed on the information collection form.

18. There are no exceptions to the Item 19 Certification at the end of the attached OMB Form 83-I.

A draft version of the information collection form is included as Attachment B. We propose to produce the form on the Commission's own printing and duplicating equipment.

B. Collections of Information Employing Statistical Methods.

Not Applicable