Justification for:
PD F 4094, “ Affidavit By Individual Surety.”
Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. A Bond of Indemnity may be required under certain conditions deemed necessary for the protection of the interest of the United States.
Indicate how, by whom, and for what purpose the information is to be used. Used to support a Bond of Indemnity executed in connection with a claim for relief on account of lost, stolen or destroyed United States securities. Without the information, the transaction cannot be completed.
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.
Describe efforts to identify duplication. Why can’t any similar information already available be used or modified for use for the purposes described in item 2 above? Duplicate information is not requested.
If the collection of information impacts small business or other small entities describe any methods used to minimize burden? This collection of information does not impact small business or other small entities.
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
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.
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 June 5, 2009, Page 27063. No comments were received.
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 55 minutes per response multiplied by the estimated number of responses (500) reflects the total burden of 460 hours.
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.
What is the annualized cost to the Federal Government? The following factors were used to estimate the annual burden to this agency:
Printing cost - estimated number of forms printed annually, multiplied by the unit cost of the forms.
Case processing cost – estimated number of forms completed, multiplied by a percentage of the unit cost of case processing.
Forms management cost - salary cost of forms management personnel.
Printing Cost 500 @ $20.00/M = $ 10.
Case Processing Cost 500 1.50/form = 750.
Forms Management Cost = 500.
Total Cost $ 1,260.
What is the reason for any program changes or adjustments reported in Items 13 or 14 of the OMB Form 83-I? N/A
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.
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? N/A
What are the exceptions to the certification statement? N/A
| File Type | application/msword |
| File Title | SUPPORTING STATEMENT |
| Author | bmetz |
| Last Modified By | jlowens |
| File Modified | 2009-08-07 |
| File Created | 2006-06-07 |