Information Collection

International Terrorism Victim Expense Reimbursement Program Application

IC 12629 under ICR 200702-1121-001 · OMB 1121-0309.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0309 can be found here:

Documents and Forms

Document Name Document Type
(D-1) Application Instructions-Final rev 82406.baw.rtf DRW1.rtf Instruction
(D-1) Application Supplemental-Current rev baw.rtf Other-Supplement to Application
International Terrorism Victim Expense Reimbursement Pro REVISED ITVERP Application w Waiver082406.baw.rtf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	International Terrorism Victim Expense Reimbursement Program Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 28 CFR 94

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Instruction			(D-1) Application Instructions-Final rev 82406.baw.rtf DRW1.rtf	No	Paper Only
Other-Supplement to Application			(D-1) Application Supplemental-Current rev baw.rtf	No	Paper Only
Form	None	International Terrorism Victim Expense Reimbursement Program Application	REVISED ITVERP Application w Waiver082406.baw.rtf	No	Paper Only

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title: Victims of International Terrorism Expense Reimbursement Program	FR Citation: 71 FR 44709

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	1,500	1,500
Annual IC Cost Burden (Dollars)	6,000	6,000

Documents for IC

Title	Document	Date Uploaded
No associated records found

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