RETURN NOTICE ON CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF A GOVERNMENT CHECK

ICR 198702-1510-001

OMB: 1510-0024

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
1510-0024 198702-1510-001
Historical Active 198609-1510-003
TREAS/FMS
RETURN NOTICE ON CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF A GOVERNMENT CHECK
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 02/18/1987
Retrieve Notice of Action (NOA) 02/06/1987
  Inventory as of this Action Requested Previously Approved
02/28/1990 02/28/1990
703 0 0
35 0 0
0 0 0

THIS FORM IS USED TO TRANSMIT INCOMPLETE EXECUTED CLAIM FORMS BACK TO THE PAYEE THAT HAS REQUESTED PAYMENT FOR HIS/HER LOST, STOLEN, OR MUTILATED UNITED STATES GOVERNMENT CHECK.

None
None


No

1
IC Title Form No. Form Name
RETURN NOTICE ON CLAIM AGAINST THE UNITED STATES FOR THE PROCEEDS OF A GOVERNMENT CHECK TFS 1503

  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 703 0 0 703 0 0
Annual Time Burden (Hours) 35 0 0 35 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.
02/06/1987


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