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Federal forms, ICRs, and supporting documents

Information Collection

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

IC 208579 under ICR 201911-1105-002 · OMB 1105-0100.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
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
Statement Claim Form
1105-0100_Referral Claim Form Final_091416.pdf 		Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

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Information Collection Instruments:
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Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Statement Claim Form 1105-0100_Referral Claim Form Final_091416.pdf Yes No Fillable Printable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 500 0 0 0 0 500
Annual IC Time Burden (Hours) 1,000 0 0 0 0 1,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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