Owner's Affidavit of Partial Destruction of Mutilated Currency

ICR 200901-1520-001

OMB: 1520-0001

Federal Form Document

Forms and Documents
IC Document Collections
ICR Details
1520-0001 200901-1520-001
Historical Active 200510-1520-002
TREAS/BEP
Owner's Affidavit of Partial Destruction of Mutilated Currency
Revision of a currently approved collection   No
Regular
Approved without change 03/31/2009
Retrieve Notice of Action (NOA) 01/30/2009
  Inventory as of this Action Requested Previously Approved
03/31/2012 36 Months From Approved 03/31/2009
150 0 150
90 0 90
0 0 0

The Office of Currency Standards, Bur of Eng & Printing requests owners of partially destroyed U.S. currency to complete a notarized affidavit (BEP 5283) for each claim sumitted when substantial portions of notes are missing.

None
None

Not associated with rulemaking

  73 FR 64662 10/30/2008
74 FR 5209 01/29/2009
No

1
IC Title Form No. Form Name
Owner's Affidavit of Partial Destruction of Mutilated Currency BEP-5283 Owner's Affadavit of Partial Destruction of Mutilated Currency

  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 150 150 0 0 0 0
Annual Time Burden (Hours) 90 90 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
No
Uncollected
Cary Conn 2028742396 [email protected]

  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.
01/30/2009


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