Treasury Direct Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 5381 Treasury Bill & Note Tender	Form and Instruction	Modified	Available
Form 5261 Reinvest notice	Form and Instruction	Modified	Available
Form 5236 Claim for proceeds of a fiscal agency check	Form and Instruction	Modified	Available
Form 5235 Report of nonreceipt, loss, theft, or destruction of fiscal agency check and application for replacement	Form and Instruction	Modified	Available
Form 5191 Application for recognition as natural guardian of a minor	Form and Instruction	Modified	Available
Form 5189 Resolution for Security transactions	Form and Instruction	Modified	Available
Form 5188 Power of Attorney for Security Transactions	Form and Instruction	Modified	Available
Form 5182 New Account Request	Form and Instruction	Modified	Available
Form 5181 Reinvest Direct Noticd	Form and Instruction	Modified	Available
Form 5180 Reinvestment request	Form and Instruction	Modified	Available
Form 5179-1 Sell Direct Request	Form and Instruction	Modified	Available
Form 5179 Security Transfer Request	Form and Instruction	Modified	Available
Form 5178 Transaction request	Form and Instruction	Modified	Available
tdfrosm.stm.pdf	Supporting Statement A	Uploaded 2007-05-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
16570	Treasury Direct Forms	Form and Instruction	Modified	Treasury Bill & Note Tender
16570	Treasury Direct Forms	Form and Instruction	Modified	Reinvest notice
16570	Treasury Direct Forms	Form and Instruction	Modified	Claim for proceeds of a fiscal agency check
16570	Treasury Direct Forms	Form and Instruction	Modified	Report of nonreceipt, loss, theft, or destruction of fiscal agency check and application for replacement
16570	Treasury Direct Forms	Form and Instruction	Modified	Application for recognition as natural guardian of a minor
16570	Treasury Direct Forms	Form and Instruction	Modified	Resolution for Security transactions
16570	Treasury Direct Forms	Form and Instruction	Modified	Power of Attorney for Security Transactions
16570	Treasury Direct Forms	Form and Instruction	Modified	New Account Request
16570	Treasury Direct Forms	Form and Instruction	Modified	Reinvest Direct Noticd
16570	Treasury Direct Forms	Form and Instruction	Modified	Reinvestment request
16570	Treasury Direct Forms	Form and Instruction	Modified	Sell Direct Request
16570	Treasury Direct Forms	Form and Instruction	Modified	Security Transfer Request
16570	Treasury Direct Forms	Form and Instruction	Modified	Transaction request

ICR Details

OMB Control No: 1535-0069	ICR Reference No: 200705-1535-001
Status: Historical Active	Previous ICR Reference No: 200406-1535-001
Agency/Subagency: TREAS/BPD	Agency Tracking No:
Title: Treasury Direct Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/02/2007
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/30/2007
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2010	36 Months From Approved	11/30/2007
Responses	350,970	0	431,632
Time Burden (Hours)	47,672	0	58,628
Cost Burden (Dollars)	0	0	0

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Abstract: Used to purchase and maintain Treasury Bills, Notes and Bonds

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Authorizing Statute(s): US Code: 31 USC Chapter 31
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 44	03/07/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 41104	07/26/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Treasury Direct Forms	5235, 5236, 5261, 5381, 5178, 5179, 5179-1, 5180, 5181, 5182, 5188, 5189, 5191	Transaction request ,   Security Transfer Request ,   Sell Direct Request ,   Reinvestment request ,   Reinvest Direct Noticd ,   New Account Request ,   Power of Attorney for Security Transactions ,   Resolution for Security transactions ,   Application for recognition as natural guardian of a minor ,   Report of nonreceipt, loss, theft, or destruction of fiscal agency check and application for replacement ,   Claim for proceeds of a fiscal agency check ,   Reinvest notice ,   Treasury Bill & Note Tender

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ICR Summary of Burden

table that charts list of burden

	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	350,970	431,632	0	-80,662	0	0
Annual Time Burden (Hours)	47,672	58,628	0	-10,956	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Figures were revised to reflect current total of responses.

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Annual Cost to Federal Government: $533,975

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/30/2007

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