CLAIMS APPLICATION-(BEARER/ORGANIZATIONS)

ICR 198111-1535-014

OMB: 1535-0015

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
127516 Migrated
ICR Details
1535-0015 198111-1535-014
Historical Active 198104-1535-012
TREAS/BPD
CLAIMS APPLICATION-(BEARER/ORGANIZATIONS)
Revision of a currently approved collection   No
Regular
Approved without change 11/25/1981
Retrieve Notice of Action (NOA) 11/11/1981
This request for clearance is approved for use through 11-30-82. For the next submission please explain clearly in the supporting statement why there is a burden change in use or program change.
  Inventory as of this Action Requested Previously Approved
12/31/1982 12/31/1982 12/31/1981
125 0 100
125 0 100
0 0 0

APPLICATION FOR RELIEF FOR LOST, STOLEN & DESTROYED US GOVERNMENT & AGENCY SECURITIES

None
None


No

1
IC Title Form No. Form Name
CLAIMS APPLICATION-(BEARER/ORGANIZATIONS) PD 1022

  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 125 100 0 25 0 0
Annual Time Burden (Hours) 125 100 0 25 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
11/11/1981


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