DEBTOR'S FINANCIAL STATEMENT

ICR 198206-3220-001

OMB: 3220-0127

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
157696 Migrated
ICR Details
3220-0127 198206-3220-001
Historical Active 198106-3220-001
RRB
DEBTOR'S FINANCIAL STATEMENT
Extension without change of a currently approved collection   No
Regular
Approved without change 06/27/1982
Retrieve Notice of Action (NOA) 06/07/1982
  Inventory as of this Action Requested Previously Approved
06/30/1985 06/30/1985 08/31/1982
1,550 0 1,550
1,550 0 1,550
0 0 0

UNDER THE RRA AND THE RUIA, THE BOARD HAS AUTHORITY TO SECURE FROM A DEBTOR A STATEMENT OF THE INDIVIDUAL'S ASSETS AND LIABILITIES. THE INFORMATION WILL BE USED FOR DETERMINING MEANS FOR RECOVERY OF OVERPAYMENT OF BENEFITS.

None
None


No

1
IC Title Form No. Form Name
DEBTOR'S FINANCIAL STATEMENT G-423

  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 1,550 1,550 0 0 0 0
Annual Time Burden (Hours) 1,550 1,550 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
06/07/1982


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