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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.