Pdf1849_stm

Supporting Statement
Justification for: PD F 1849, "Disclaimer and Consent With Respect to United States
Savings Bonds/Notes."”
1.

Explain the circumstances that make this collection of information necessary.
Identify any legal or administrative requirements that necessitate the collection. A
disclaimer and consent may be necessary when, as the result of an error in registration or
otherwise, the payment, refund of purchase price, or reissue of savings bonds/notes as
requested by one person would appear to affect the right, title or interest of some other
person.

2.

Indicate how, by whom and for what purpose is this information used? The form is
completed by the person giving his/her disclaimer and consent to the requested
transaction. Without the use of this form, the Bureau could create a potential legal
liability to the United States Government by incorrectly disposing of savings
bonds/notes.

3.

Describe whether, and to what extent, the collection of information involves the use
of automated, electronic, mechanical, or other technological collection techniques or
other forms of information technology? What consideration is given to use
information technology to reduce burden? Public Debt has been a leader in e-Gov,
providing the public with options for conducting financial transactions online for several
years. To provide our customers additional options for submitting information
electronically, we are taking the following steps: a technical project team is exploring
options (such as pay.gov) and will select the mechanism(s)/infrastructure needed;
concurrently, reengineering of business processes (and forms) is being conducted as the
result of a reorganization of our major business lines.

4.

Describe efforts are used to identity duplication? Why can’t any similar
information already available be used or modified for use for the purposes
described in Item 2 above? The form will be reviewed annually to identify duplicate
information.

5.

If this collection of information impacts small businesses or other small entities,
what methods are used to minimize burden? This collection of information does not
impact small business or other small entities.

6.

What consequences to Federal program or policy activities and what, if any,
technical or legal obstacles to reducing burden will occur if this collection is not
conducted or is conducted less frequently? N/A.

7.

Is this collection of information conducted in a manner consistent with the
guidelines of 5 CFR 1320.6? The collection of information cannot be conducted less
frequently because the collection is initiated for a single purpose.

8.

What effort was made to notify the general public about this collection of
information? The Bureau’s notice was published in the Federal Register on Jan 10,
2008, Page 1914.

9.

What decision was made to provide any payment or gift to respondents, other than
reenumeration of contractors or grantees? N/A

10. What assurance of confidentiality was provided to respondents and what was the

basis for the assurance in statute, regulations, or agency policy? In accordance with
the Privacy Act of 1974, information furnished by the public is assured confidentiality.
11. What justification is there for questions of a sensitive nature? There are no questions

of a sensitive nature.
12. What is the estimated hour burden of this collection of information? The average

time needed is 6 minutes per response multiplied by the estimated number of responses
(7,000) reflects the total burden of 700 hours.
13. What is the estimated total annual cost burden to respondents or recordkeepers

resulting from this collection of information? Estimated cost burden to respondents is
not available at this time.
14. What is the annualized cost to the Federal Government? The following factors were

used to estimate the annual burden to this agency:
a. Printing cost - estimated number of forms printed annually, multiplied by the unit
cost of the forms.
b. Case processing cost - estimated number of forms completed, multiplied by a
percentage of the unit cost of case processing.
c. Forms management cost - salary cost of forms management personnel.
Printing Cost
Case processing cost
Forms Management Cost
Total Cost

7,000 @ $.02
7,000 @ 1.50/form

= $ 140.
= $10,500.
=
500.
$11,140.

15. What is the reason for any program changes or adjustments reported in Items 13 or

14 of the OMB Form 83-I? Figures were update to reflect current total of responses.
16. For collections of information whose results will be published, outline plans for

tabulation and publication. The results of the collection of this information will not be
published for statistical use.

17. If seeking approval to not display the expiration date for OMB approval of this

information collection, what are the reasons that the display would be
inappropriate? We believe the public interest will be better served by not printing an
expiration date on Form PD F 1832. The time period during which the current edition of
the form will continue to be usable cannot be predicted. It could easily span several
cycles of review and OMB clearance renewal. In addition, usage fluctuates
unpredictably. This makes it necessary to maintain a substantial inventory of forms in
the supply line at all times. This includes supplies owned by the Bureau of Public Debt
and Federal Reserve Banks. Reprinting of the form cannot be reliably scheduled to
coincide with an OMB approval expiration date. Not printing the expiration date on the
form will also avoid confusion among the public who may have identical forms with
different expiration dates in their possession. Without printing the expiration date,
supplies of the form could continue to be used without question. This would reduce costs
incurred through additional printing.
18. What are the exceptions to the certification statement? N/A