OMB control number
Statement of Claim for filing of Claims in the Guam Claims Program Pursuant to the Guam World War II Loyalty Recognition Act
OMB 1105-0102 · DOJ/LA.
OMB 1105-0102
Guam Program Claims Form Abstract DOJ’s Foreign Claims Settlement Commission is requesting PRA approval of a new collection that would request information regarding the injuries suffered by individuals as a result of the attack and occupation of Guam by Imperial Japanese military forces during World War II, or incident to the liberation of Guam by United States military forces for the purpose of obtaining compensation pursuant to the Guam World War II Loyalty Recognition Act, Title XVII, Public Law 114-328 (December 23, 2016).
The latest form for Statement of Claim for filing of Claims in the Guam Claims Program Pursuant to the Guam World War II Loyalty Recognition Act expires 2023-09-30 and is listed under ICR 202006-1105-001.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form FCSC-2 Statement of Claim for filing of Claims in the Guam Claims Program Pursuant to the Guam World War II Loyalty Recognition Act | Form and Instruction |
| SORN Submission.pdf | Supplementary Document |
| Guam Claim Form - Chamorro.pdf | Supplementary Document |
| Guam Claim Form - English.pdf | Supplementary Document |
| SORN Letter to Mick Mulvaney_1105-NEW.pdf | Supplementary Document |
| omb-83i - Guam - Signed Final (002).pdf | Supporting Statement A |
 Statement of Claim for filing of Claims in the Guam Claims Program Pursuant to the Guam World War II Loyalty Recognition Act |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202006-1105-001 | Revision of a currently approved collection | 2020-06-26 | Approved without change | |
| 201702-1105-001 | New collection (Request for a new OMB Control Number) | 2017-04-18 | Approved without change |