VOUCHER FOR WORK PERFORMED, AND FINAL VOUCHER FOR PAYMENT

ICR 198511-2125-002

OMB: 2125-0507

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2125-0507 198511-2125-002
Historical Active 198209-2125-001
DOT/FHWA
VOUCHER FOR WORK PERFORMED, AND FINAL VOUCHER FOR PAYMENT
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 02/10/1986
Retrieve Notice of Action (NOA) 11/21/1985
  Inventory as of this Action Requested Previously Approved
11/30/1988 11/30/1988
54 0 0
15,174 0 0
0 0 0

VOUCHERS ARE NECESSARY TO DOCUMENT THE AMOUNT OF A RECIPIENT'S CLAIM AS REQUIRED BY U.S.C. 121. INFORMATION RECEIVED IS ONLY THAT REQUIRED BY STATUTE TO MAKE PAYMENT TO THE RECIPIENT AND TO PROPERLY ENTER EXPENDITURE DATA INTO THE FHWA ACCOUNTING SYSTEM.

None
None


No

1
IC Title Form No. Form Name
VOUCHER FOR WORK PERFORMED, AND FINAL VOUCHER FOR PAYMENT PR-20, FHWA-1447, FHWA-1175

  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 54 0 0 0 54 0
Annual Time Burden (Hours) 15,174 0 0 0 15,174 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.
11/21/1985


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