OMB control number

United States Victims of State Sponsored Terrorism Fund Application

OMB 1123-0013 · DOJ/CD.

OMB 1123-0013

The United States Victims of State Sponsored Terrorism Fund (Fund) provides compensation to certain individuals who were injured as a result of an international act of terrorism by a state sponsor of terrorism. The Justice for United Victims of State Sponsored Terrorism Act sets forth criteria for eligibility under the Fund, such as a final judgment issued against a state sponsor of terrorism. The Fund Application Form requests information to determine eligibility and amount of compensation.

The latest form for United States Victims of State Sponsored Terrorism Fund Application expires 2029-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form OMB #1123-0013 USVSST Certification of Personal Representative Form and Instruction
Form OMB #1123-0013 USVSST Direct Deposit Form Form and Instruction
Form OMB #1123-0013 USVSST informer Information and Acknowledgement Form and Instruction
Form OMB #1123-0013 USVSST Hearing Request Form Form and Instruction
Form OMB #1123-0013 USVSST Authorization for Communication Form and Instruction
Form OMB #1123-0013 UVSST Attorney's Fee Certification Form and Instruction
Form OMB #1123-0013 USVSST Application's Acknowledgement of Statutory Limitation on Attorneys' Fees Form and Instruction
Form OMB #1123-0013 USVSST Change of Attorney Form Form and Instruction
Form OMB #1123-0013 USVSST Fund Application Form Form and Instruction
Form Notice of Filing C USVSST Notice of Claim Form and Instruction
Macro Form 5500 Anomaly Table.pdf Public Comments
CENTRAL PENSION FUND ANOMALIES AND RED FLAGS.pdf Public Comments
000 MASTER_COMPREHENSIVE_FEDERAL_SUBMISSION.pdf Public Comments
Comprehensive Pension and Welfare Audit Records and Fraud Estimates.xlsx Public Comments
2_The_OEFCU_SCAM(1)(2)_compressed.pdf Public Comments
Growth of Pension Accounts with Zero Participants and Assets.pdf Public Comments
Milliman Forensic Audit- Red Flags, Anomalies, and Case Filings.pdf Public Comments
FinCEN-Treasury OIG Filing and Judicial Misconduct Investigation Table.pdf Public Comments
05 anomalies_step1' with you' with you.pdf (document unavailable) Public Comments
06 Abrupt_Disappearances' with you' with you.pdf Public Comments
PC_202603-1123-001_032226_080340_1.pdf Public Comments
VSSTF Supporting Statement A_3.27.26_VSSTF responses to comments, incl public 3.30.26.docx Supporting Statement A
Nonmaterial Change Justification 1123-0013.docx Justification for No Material/Nonsubstantive Change
Memo 1123-0013.docx Supplementary Document
Published 30-Day Notice.pdf Supplementary Document
VSST ACH Form 9.20.16.pdf Supplementary Document
PR's Acknowledgment of Attorney's Compliance with Limitation on Attorney.pdf Supplementary Document
Notice of Filing Claim 10.5.16.pdf Supplementary Document
Hearing Request Form.pdf Supplementary Document
Draft List of Individuals (for Notice of Filing Claim) 10.6.16 1115am.pdf Supplementary Document
Draft Distribution Plan 10.07.16.pdf Supplementary Document
Consent to Distribution_10.5.16 v2.pdf Supplementary Document
Authorization for Communication Correspondence PR_10.5.16.pdf Supplementary Document
Authorization for Communication Correspondence nonPR 10.5.16.pdf Supplementary Document
Attorney Change or Removal Form.pdf Supplementary Document
Attorney Certification for Fee Limitation_PR.pdf Supplementary Document
Attorney Certification for Fee Limitation nonPR 10.5.16.pdf Supplementary Document
Applicant's Acknowledgment of Attorney's Compliance with Limitation on A.10.5.16.pdf Supplementary Document
42 USC 10609.pdf Supplementary Document
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction
USVSST Application Form and Instruction

All Historical Document Collections

202603-1123-001 Approved with change	Revision of a currently approved collection	2026-03-12
202601-1123-001 Improperly submitted and continue	Revision of a currently approved collection	2026-01-23
202304-1123-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-04-17
202210-1123-001 Approved without change	Revision of a currently approved collection	2022-11-03
201910-1123-001 Approved without change	Extension without change of a currently approved collection	2019-10-16
201610-1123-001 Approved without change	Revision of a currently approved collection	2016-10-24
201607-1123-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2016-07-29
201607-1123-001 Approved with change	New collection (Request for a new OMB Control Number)	2016-07-08