Certificate of Appointment and Request for Payment

ICR 200104-1535-008

OMB: 1535-0133

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
16692 Migrated
ICR Details
1535-0133 200104-1535-008
Historical Active 199804-1535-007
TREAS/BPD
Certificate of Appointment and Request for Payment
Extension without change of a currently approved collection   No
Regular
Approved without change 06/13/2001
Retrieve Notice of Action (NOA) 04/16/2001
  Inventory as of this Action Requested Previously Approved
06/30/2004 06/30/2004 06/30/2001
1,000 0 1,000
330 0 330
0 0 0

Used by court-appointed or other authorized individual to request reissue on behalf of an incompetent, minor, or other person under a legal disability.

None
None


No

1
IC Title Form No. Form Name
Certificate of Appointment and Request for Payment PD-F-5385

  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 1,000 0 0 0 0
Annual Time Burden (Hours) 330 330 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.
04/16/2001


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