APPLICATION FOR DISPOSITION OF RETIREMENT PLAN AND/OR INDIVIDUAL RETIREMENT BONDS WITHOUT ADMINISTRATION OF DECEASED OWNER'S ESTATE

ICR 198409-1535-013

OMB: 1535-0032

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1535-0032 198409-1535-013
Historical Active 198304-1535-018
TREAS/BPD
APPLICATION FOR DISPOSITION OF RETIREMENT PLAN AND/OR INDIVIDUAL RETIREMENT BONDS WITHOUT ADMINISTRATION OF DECEASED OWNER'S ESTATE
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 0 200
500 0 100
0 0 0

THE FORM IS MADE AVAILABLE TO HEIRS OF RETIREMENT PLAN AND INDIVIDUAL RETIREMENT BOND OWNERS TO ENABLE THEM TO APPLY FOR DISPOSITION OF SUCH BONDS UPON THE DEATH OF THE OWNERS WHEN NO BENEFICIARIES ARE DESIGNATE ON THE BONDS

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR DISPOSITION OF RETIREMENT PLAN AND/OR INDIVIDUAL RETIREMENT BONDS WITHOUT ADMINISTRATION OF DECEASED OWNER'S ESTATE PD 3565

  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 1,000 200 0 800 0 0
Annual Time Burden (Hours) 500 100 0 400 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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