Information Collection

Notice of Reclamation and Debit Request for Recurring Benefit Payments

IC 15406 under ICR 200904-1510-009 · OMB 1510-0043.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1510-0043 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FMS-133 Notice of Reclamation and Debit Request for Recurring Benefit Payments	Form
FMS-133 Direct Deposit EFT Federal Recurring Payments-Notice of FMS 133 form.pdf	Form
FMS-135 Request for Debit EFTFederal Recurring Payment FMS 135 form.pdf	Form

IC Title:

Notice of Reclamation and Debit Request for Recurring Benefit Payments

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FMS-133	Direct Deposit EFT Federal Recurring Payments-Notice of Reclamation	FMS 133 form.pdf		No		Printable Only
Form	FMS-135	Request for Debit EFTFederal Recurring Payment	FMS 135 form.pdf		No		Printable Only

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	396,674	396,674
Annual IC Time Burden (Hours)	79,335	79,335
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.