Information Collection

Special Form Of Request For Payment Of United States And Retirement Securities Where Use Of A Detached Request Is Authorized

IC 127454 under ICR 198409-1535-002 · OMB 1535-0004.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

SPECIAL FORM OF REQUEST FOR PAYMENT OF UNITED STATES AND RETIREMENT SECURITIES WHERE USE OF A DETACHED REQUEST IS AUTHORIZED

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	PD 1522				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	8,000	-49,000	57,000
Annual IC Time Burden (Hours)	4,000	-15,000	19,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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