Debt Collection Financial Statement

ICR 200108-3067-004

OMB: 3067-0122

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
31998 Migrated
ICR Details
3067-0122 200108-3067-004
Historical Active 199804-3067-006
FEMA
Debt Collection Financial Statement
Revision of a currently approved collection   No
Regular
Approved without change 10/26/2001
Retrieve Notice of Action (NOA) 08/27/2001
  Inventory as of this Action Requested Previously Approved
10/31/2004 10/31/2004 11/30/2001
600 0 2,000
450 0 1,500
0 0 0

FEMA Form 22-13, Debt Collection Financial Statement is sub- mitted by FEMA's debtors listing name, addresses and other identifying data, their employment and income, their property and their debts. Debtors submit these statements when requesting installment repayment plans or termination of collection actions due to proverty or suspension or when compromising debts owned to FEMA.

None
None


No

1
IC Title Form No. Form Name
Debt Collection Financial Statement 22-13

  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 600 2,000 0 -1,400 0 0
Annual Time Burden (Hours) 450 1,500 0 -1,050 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
08/27/2001


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