RETURN NOTICE ON CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF A GOVERNMENT CHECK

ICR 198310-1510-003

OMB: 1510-0024

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1510-0024 198310-1510-003
Historical Active 198109-1510-004
TREAS/FMS
RETURN NOTICE ON CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF A GOVERNMENT CHECK
Revision of a currently approved collection   No
Regular
Approved without change 11/25/1983
Retrieve Notice of Action (NOA) 10/14/1983
This request for clearance is approved for 18 months. Since the "Recertification Project" will be implemented during FY84, this will allow time for its implementation and the elimination of this form.
  Inventory as of this Action Requested Previously Approved
05/31/1985 05/31/1985 12/31/1983
787 0 1,967
39 0 98
0 0 0

THE FORM IS USED TO TRANSMIT INCOMPLETE CLAIM FORMS BACK TO PAYEE THAT HAS REQUESTED PAYMENT FOR A LOST, STOLEN OR MUTILATED U.S. GOVERNMENT CHECK.

None
None


No

1
IC Title Form No. Form Name
RETURN NOTICE ON CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF A GOVERNMENT CHECK TFS 1503

  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 787 1,967 0 -1,180 0 0
Annual Time Burden (Hours) 39 98 0 -59 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
10/14/1983


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