CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF GOVERNMENT CHECK OR CHECKS

ICR 198109-1510-003

OMB: 1510-0018

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1510-0018 198109-1510-003
Historical Active 198104-1510-018
TREAS/FMS
CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF GOVERNMENT CHECK OR CHECKS
Revision of a currently approved collection   No
Regular
Approved without change 10/16/1981
Retrieve Notice of Action (NOA) 09/11/1981
  Inventory as of this Action Requested Previously Approved
12/31/1984 12/31/1984 12/31/1981
59,115 0 66,000
14,779 0 240,615
0 0 0

THIS FORM IS USED TO RECORD INFORMATION PERTINENT TO ADJUDICATING THE PAYEE'S REQUEST FOR PAYMENT FOR ONE OR MORE LAST, MUTILATED, OR STOLEN GOVERNMENT CHECKS.

None
None


No

1
IC Title Form No. Form Name
CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF GOVERNMENT CHECK OR CHECKS TFS 1133C

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 59,115 66,000 0 0 -6,885 0
Annual Time Burden (Hours) 14,779 240,615 0 0 -225,836 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/11/1981


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