This request for
clearance is approved for 18 months. Since the "Recertification
Project" will be implemented during FY84, this will allow time for
its implementation and the elimination of this form.
Inventory as of this Action
Requested
Previously Approved
05/31/1985
05/31/1985
12/31/1983
787
0
1,967
39
0
98
0
0
0
THE FORM IS USED TO TRANSMIT
INCOMPLETE CLAIM FORMS BACK TO PAYEE THAT HAS REQUESTED PAYMENT FOR
A LOST, STOLEN OR MUTILATED U.S. GOVERNMENT CHECK.
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.