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

ICR 199107-1535-008

OMB: 1535-0032

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1535-0032 199107-1535-008
Historical Active 198501-1535-004
TREAS/BPD
APPLICATION FOR DISPOSITION OF RETIREMENT PLAN AND/OR INDIVIDUAL RETIREMENT BONDS WITHOUT ADMINISTRATION OF DECEASED OWNER'S ESTATE
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 11/22/1991
Retrieve Notice of Action (NOA) 07/22/1991
  Inventory as of this Action Requested Previously Approved
08/31/1994 08/31/1994
50 0 0
17 0 0
0 0 0

S ESTATE, DECENDENTS, CERTIFICATIONS' USED BY HEIRS OF DECEASED OWNERS OF RETIREMENT PLAN AND/OR INDIVIDUAL RETIREMENT SAVINGS BONDS TO REQUEST DISPOSITION OF THE BONDS WHEN NO BENEFICIARIES ARE DESIGNATED.

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 F 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 50 0 0 294 -244 0
Annual Time Burden (Hours) 17 0 0 100 -83 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.
07/22/1991


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