Supporting Statement
OMB Number 1530-0012
FS Form 5135 – “Voucher for Payment of Awards”
Justification
Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.
Under the International Claims Settlement Act of 1949, as amended, the War Claims Act of 1928, as amended, and the War Claims Act of 1928, The Department of the Treasury has the responsibility of making payments on awards and on divested accounts from funds made available for these purposes.
Indicate how, by whom, and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.
FS Form 5135, Voucher for Payment of Awards, is used when funds become available or an application is made for funds already available. This form is a voucher application showing the amount authorized for payment. It is also used to identify the person signing the voucher as the person entitled to receive the payment by verifying signatures against records. If a discrepancy is discovered, additional information or an explanation is required.
Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.
The form is available from the Bureau of the Fiscal Service and also on the Internet as a fill-in PDF form.
4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.
The Judgment Fund Branch is the only office making payments under the International Claims Settlement Act of 1949, the War Claims Act of 1928, and the War Claims Act of 1948. Since no other office is involved in processing payments for these awards, there is no duplication of this information collection.
5. If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83-I), describe any methods used to minimize burden.
This collection of information does not involve small businesses.
6. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.
There would be no consequences to Federal program or policy activities trying to change the frequency of collection. This collection of information is conducted on an annual basis when funds become available or an application is made for funds already available.
7. Explain any special circumstances that would cause an information collection to be conducted in a manner: *requiring respondents to report information to the agency more often than quarterly; *requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it; requiring respondents to submit more than an original and two copies of any document; etc.
The collection of information cannot be conducted less frequently because the collection is initiated for a single purpose.
8. If applicable, provide a copy and identify the date and page number of publication in the Federal Register of the agency’s notice, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden.
The Bureau’s notice was published in the Federal Register on October 31, 2018, page 54809. No comments were received.
9. Explain any decision to provide any payment or gift to respondents, other than reenumeration of contractors or grantees.
There are no gifts or payments to respondents associated with this information collection.
10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation, or agency policy.
Aside from protections contained in the Privacy Act, there is no guarantee of confidentiality.
11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.
There are no questions of a sensitive nature. Personally identifiable information(PII) collected on this form such as name and social security number is necessary to establish entitlement and for the proper distribution of related payments. An applicable System of Records Notice for this information was published October 15, 2012. System of Records Name: Treasury/FMS.003 – Claims and Inquiry Records on Treasury Checks, and International Claimants—Treasury/FMS. The privacy impact assessment (PIA) conducted for this collection of information can be found at https://www.fiscal.treasury.gov/files/pia/PPSPIA.pdf
12. Provide estimates of the hour burden of the collection of information. The statement should: *indicate the number of respondents, frequency of response, annual hour burden; and an explanation of how the burden was estimated.
Number of respondents ---1,400
Frequency of responses -- Annually (one form per respondent)
Annual Burden hours --- 700 hours (.5 hours per form)
This burden was based on a combination of factors: a) Past experience working with the respondents who have come to the office to complete the form: b) Running tests with employees of the office to see how long it took them to complete the form: and c) An estimate of the time it would take the respondents to have a corporate seal placed on the form similar to notarization.
13. Provide an estimate for the total annual cost burden to respondents or recordkeepers resulting from the collection of information.
There is no annual cost to respondent. The respondent has to complete the form (by hand if desired, or typed) and send it in. The only cost the respondent may incur would be the cost of postage to mail in the form.
14. Provide estimates of annualized costs to the Federal government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), and any other expense that would not have been incurred without this collection of information.
Estimates of annualized costs to the Federal Government:
Mailing expense for 700 forms (one per respondent)
Cost of $0.39 per form = 1400x 0.39 = $ 546.00
Printing cost to the Federal Government based on 1400 forms
At a cost of: $0.25 per form = 1400 x 0.25= 350.00
Information on form reviewed and verified by Staff Analyst
(15 minutes per form) at an hourly rate of $17.19.
$17.19 = 1 x 15/60 x$17.19x 1400 6,016.50
Data entered into the computer, reviewed, verified and printed.
(15 minutes per form) at an hourly rate of $17.19
$17.19= 1x15/60x$17.19 x1400 = 6,016.50
Approved by Supervisor at an hourly rate of :
$25.45= 1x15/60 x$25.45 x1400= $ 8,907.50
Total estimated cost: $21,836.50
15. Explain the reasons for any program changes or adjustments reported in items 13 or 14 of the OMB Form 83-1.
There are no changes in the burden of hours. This request is for renewal purposes only.
16. For collections of information whose results will be published. Outline plans for tabulation and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.
The results of this information collection will not be published for statistical purpose.
17. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.
We believe the public interest will be better served by not printing an expiration date on the form. Printing the expiration date on the form will result in increased costs because of the need to replace inventories that become obsolete by passage of the expiration date each time OMB approval is needed. Without printing the expiration date, supplies of the form could continue to be used. Not printing the expiration date on the form will also avoid confusion among users who may have identical forms with different expiration dates in their possession.
For the above reasons, we request authorization to omit printing the expiration date on this form and permission to use previous versions of FS Form 5135.
18. Explain each exception to the certification statement identified in item 19 “Certification for Paperwork Reduction Act Submissions” of OMB Form 83-1.
There are no exceptions to the certification statement.
Collections of Information Employing Statistical Methods
The agency should be prepared to justify its decision not to use statistical methods in any case where such methods might reduce burden or improve accuracy of results. When Item 17 on the Form OMB 83-I is checked, “Yes,” the following documentation should be included in the Supporting Statement to the extend that it applies to the methods proposed:
This information collection does not employ statistical methods.
| File Type | application/msword |
| File Title | SUPPORTING STATEMENT |
| Author | cbrice |
| Last Modified By | SYSTEM |
| File Modified | 2018-12-21 |
| File Created | 2018-12-21 |