Reporting and Recordkeeping Requirements

Reporting and Recordkeeping Requirements 1.xlsm

Assignments of Payments and Joint Payment Authorization; Request for Waiver

Reporting and Recordkeeping Requirements

OMB: 0560-0183

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INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-I: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO. 0560-0183










Assignments of Payments and Joint Payment Authorization; Request for Waiver



DATE PREPARED


August 5, 2021











IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN











REPORTS
RECORDS RESPONDENT COST



















TOTAL BURDEN HOURS

TOTAL







FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS (Col. F x G) NO. OF ANNUAL RECORD- COST TOTAL
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER (H) RECORD- HOURS PER KEEPING HOURS PER COST
REGS.




so state)
PER (Col. D x E) RESPONSE

KEEPERS RECORD- (Col. I x J) HOUR (Col. H x L)








RESPONDENT

EXEMPT NON-EXEMPT
KEEPER


(A) (B) (C) (D) (E) (F) (G)

(I) (J) (K) (L) (M)
7 CFR 1404.4 Assignment of Payments CCC-36 or CCC-36 (SP) 536,540 1 536,540 0.17
89,423


$53.71 4,802,908
None Joint Payment Authorization CCC-37 or CCC- 37 (SP) 74,354 1 74,354 0.17
12,392


$53.71 665,566
7 CFR 1404.4 Notice of Assignment FSA-251 7 1 7 0.17
1


$53.71 53
None Instrument of Assignment FSA-252 7 1 7 0.08
1


$53.71 53
31 CFR Part 208 Request For FSA Payment of Federal Benefits by Check FPAC-FM-12 89,583 1 89,583 0.17
14,871


$53.71 798,709




























































































116,687





SUBTOTAL


700,491
0 116,687

0.00
6,267,289

TOTAL OF ALL PAGES


700,491

116,687

0.00
6,267,289
TOTAL - COLUMNS "F" AND "I" = OMB 83-I, 13b; COLUMNS "H" AND "K" = OMB 83-I, 13c


700,491

116,687




File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

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