REQUEST FOR REISSUE OF UNITED STATES RETIREMENT PLAN OR INDIVIDUAL RETIREMENT BONDS TO CHANGE BENEFICIARY OR REFLECT CHANGE OF NAME

ICR 198409-1535-011

OMB: 1535-0033

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1535-0033 198409-1535-011
Historical Active 198304-1535-008
TREAS/BPD
REQUEST FOR REISSUE OF UNITED STATES RETIREMENT PLAN OR INDIVIDUAL RETIREMENT BONDS TO CHANGE BENEFICIARY OR REFLECT CHANGE OF NAME
No material or nonsubstantive change to a currently approved collection   No
Emergency 09/11/1984
Approved with change 09/11/1984
Retrieve Notice of Action (NOA) 09/11/1984
  Inventory as of this Action Requested Previously Approved
01/31/1985 01/31/1985 01/31/1985
1,000 0 150
340 0 50
0 0 0

THE FORM IS MADE AVAILABLE TO RETIREMENT PLAN AND INDIVIDUAL RETIREMENT PLAN AND INDIVIDUAL RETIREMENT BOND OWNERS TO ENABLE THEM TO REQUEST A CHANGE OF BENEFICIARY (PAYABLE ON DEATH) OR TO REFLECT A CHANGE IN NAME (SUCH AS, BY MARRIAGE).

None
None


No

1
IC Title Form No. Form Name
REQUEST FOR REISSUE OF UNITED STATES RETIREMENT PLAN OR INDIVIDUAL RETIREMENT BONDS TO CHANGE BENEFICIARY OR REFLECT CHANGE OF NAME PD 3564

  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 1,000 150 0 850 0 0
Annual Time Burden (Hours) 340 50 0 290 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.
09/11/1984


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