Application for Relief on Account of Loss, Theft, or Destruction of U.S. Savings and Retirement Securities; Statement Concerning U.S. Securities

ICR 199702-1535-004

OMB: 1535-0013

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1535-0013 199702-1535-004
Historical Active 199401-1535-001
TREAS/BPD
Application for Relief on Account of Loss, Theft, or Destruction of U.S. Savings and Retirement Securities; Statement Concerning U.S. Securities
Extension without change of a currently approved collection   No
Regular
Approved without change 04/01/1997
Retrieve Notice of Action (NOA) 02/25/1997
  Inventory as of this Action Requested Previously Approved
04/30/2000 04/30/2000 04/30/1997
80,000 0 80,000
32,000 0 32,000
0 0 0

Used by owner(s) or others having knowledge to request substitute securities or payment of lost, stolen, or destroyed securities.

None
None


No

1
IC Title Form No. Form Name
Application for Relief on Account of Loss, Theft, or Destruction of U.S. Savings and Retirement Securities; Statement Concerning U.S. Securities PD-F-1048, PD-F-2243

  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 80,000 80,000 0 0 0 0
Annual Time Burden (Hours) 32,000 32,000 0 0 0 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.
02/25/1997


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