Approved with
the following conditions: 1) the word "men" shall be omitted from
line one, and 2) the next submission of this form shall use
simplified language. Your request to omit the expiration date is
denied because this is an existing collection without an OMB
control number. We will consider a request for the omission of the
expiration date in the next OMB review of this form.
Inventory as of this Action
Requested
Previously Approved
09/30/1992
09/30/1992
500
0
0
500
0
0
0
0
0
THE FORMS ARE USED TO SUPPORT
CLAIMS/APPLICATIONS FOR RELIEF ON ACCOUN OF LOST, STOLEN OR
DESTROYED SECURITIES. THE FORM SERVES AS AN INDEMNIFICATION
AGREEMENT TO GUARANTEE REIMBURSEMENT TO THE GOVERNMENT IN THE EVENT
OF AN ERRONEOUS PAYMENT OF SECURITIES ON WHICH RELIEF WAS
PREVIOUSLY OBTAINED FROM THE DEPARTMENT.
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.