OMB control number

International Terrorism Victim Expense Reimbursement Program Application

OMB 1121-0309 · DOJ/OJP.

OMB 1121-0309

The application is nesssary for victims/claimants to request reimbursement of funds. Collection of information is necessary to assist OVC staff to objectively, fairly, and equitably determine distribution of reimbursement of funds and account for allocation of funds. Respondent will include U.S. government employees and U.S. Nationals who become victims of international terrorism that occurs outside of the U.S.

The latest form for International Terrorism Victim Expense Reimbursement Program Application expires 2021-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
International Terrorism Victim Expense Reimbursement Program Form
SupportingStatement-2021.doc.docx Supporting Statement A
6DocTheLaw1-Current.rtf Supplementary Document
International Terrorism Victim Expense Reimbursement Program Form

All Historical Document Collections

202110-1121-001 Approved without change	Reinstatement without change of a previously approved collection	2022-07-22
201712-1121-003 Approved without change	Extension without change of a currently approved collection	2017-12-29
201409-1121-002 Approved without change	Extension without change of a currently approved collection	2014-09-24
201306-1121-003 Approved without change	Reinstatement without change of a previously approved collection	2013-06-27
201003-1121-002 Approved without change	Extension without change of a currently approved collection	2010-04-19
200702-1121-001 Approved without change	Extension without change of a currently approved collection	2007-02-21
200608-1121-005 Approved with change	New collection (Request for a new OMB Control Number)	2006-08-14
200505-1121-001 Comment filed on proposed rule	New collection (Request for a new OMB Control Number)	2005-05-03