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Assignment Form

OMB: 1510-0035

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Supporting Statement FOR

Paperwork Reduction Act SubmissionS

OMB No. 1510-0035

Assignment Form


  1. Justifications.


1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.


Answer: Under the International Claims Settlement Act of 1949, as amended, the War Claims Act of 1928

As amended, and the War Claims Act of 1948, The Department of the Treasury has the responsibility of

Making payments on awards and on divested accounts from funds made available for these purposes.


2. Indicate how, by whom, and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.


Answer: The Assignment Form is used by an award holder who wishes to assign or transfer all or part of

His award to another person. In assigning the award, the award holder forfeits his rights to the portion assigned and the assignee becomes the owner of that portion. This form is often used to assign a portion to a lawyer to cover attorney’s fees.


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, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.


Answer: No consideration is being made at the present time to use any form of automated or any form of information technology in this program area. There are no technical obligations impending reductions in burden.


4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.


Answer: The Judgment Fund Branch is the only office making payments under the International Claims Settlement Act of 1949, the War Claims Act of 1928, and the War Claims Act of 1948. Since no other office is involved in processing payments for these awards, duplication of this information collection should not occur.


5. If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83-I), describe any methods used to minimize burden.


Answer: This information does not involve small businesses.


6. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.


Answer: There would be no consequences to Federal program or policy activities trying to change the frequency of collection. This collection of information is requested on an as needed basis, whenever an award holder wishes to assign a portion of his award to someone else.


7. Explain any special circumstances that would cause an information collection to be conducted in a manner: *requiring respondents to report information to the agency more often than quarterly; *requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it; requiring respondents to submit more than an original and two copies of any document; etc.


Answer: There are no special circumstances that requires the collection to be conducted in a manner inconsistent with 5 CFR 1320.6


8. If applicable, provide a copy and identify the date and page number of publication in the Federal Register of the agency’s notice, required by 5 CFR 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden.


Answer: A pre-clearance was published in the Federal Register on September 18, 2006, Volume 71, and Number 180 page 54710. No comments were received regarding this information collection.


9. Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.


Answer: There are no gifts or payments to respondents associated with this information collection.


10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation, or agency policy.


Answer: An assurance of confidentiality is not required.

11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.


Answer: There are no sensitive questions in the information collection.


12. Provide estimates of the hour burden of the collection of information. The statement should: *indicate the number of respondents, frequency of response, annual hour burden; and an explanation of how the burden was estimated.


Answer: Number of respondents----150 Frequency of responses---Annually (one form per respondent)

Annual Burden hours 75 hours (.5 hours per form). This was based on a combination of factors: a) Past experience working with the respondents who have come to the office for assistance in completing the form. b) Running tests with employees in the office to see how long it took to complete the form. and c) An estimate of the time it would take the respondents to have a corporate seal placed on the form similar to notarization.

13. Provide an estimate for the total annual cost burden to respondents or record keepers resulting from the collection of information. (Do not include the cost of any hour burden shown in Items 12 and 14).


Answer: There is no annual cost to respondent. The respondent has to complete the form (by hand if desired, or typed) and send it in. There are no start up costs of operational and maintenance costs. The only cost the respondent may incur would be cost of postage to mail in the form.


14. Provide estimates of annualized costs to the Federal government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), and any other expense that would not have been incurred without this collection of information. Agencies may also aggregate cost estimates from Items 12, 13, and 14 in a single table.


Answer: Estimates of annualized cost to the Federal Government:


  1. Mailing expense for 150 forms (one per respondent)

Cost $0.39 per form = 150 x 0.39= $58.50

  1. Printing cost to the Federal Government based on 150

At a cost of $0.25 per form = 150 x 0.25= $37.50


  1. Information on form reviewed and verified by Staff

(15 minutes per form) at an hourly rate of $16.58=

1x 15/60 x$1658 x150= $621.75

  1. Data entered into computer, reviewed, verified and

Printed. (15 minutes per form) at an hourly rate

of $1658= 1 x15/60 x$16.58 x150= $621.75


Approved by Supervisor at an hourly rate of

$25.45= 1x15/60 x$25.45 x150 = $954.38


Total estimated cost: ----------------------------------------------------------$2,293.88



15.Explain the reasons for any program changes or adjustments reported in items 13 or 14 of the OMB Form 83-1.

Answer: There are no changes in the burden hours. This request is for renewal purposes only.



16. For collections of information whose results will be published, outline plans for tabulation and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.


Answer: The results of this information collection will not be published for statistical purpose.


17. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.


Answer: Not applicable.


18. Explain each exception to the certification statement identified in Item 19, “Certification for Paperwork Reduction Act Submissions,” of OMB Form 83-I.


Answer: Not applicable, there are no exceptions.


B. Collections of Information Employing Statistical Methods


The agency should be prepared to justify its decision not to use statistical methods in any case where such methods might reduce burden or improve accuracy of results. When Item 17 on the Form OMB 83-I is checked, “Yes,” the following documentation should be included in the Supporting Statement to the extend that it applies to the methods proposed:


Answer: This information collection does not employ statistical methods.

File Typeapplication/msword
File TitleSUPPORTING STATEMENT
Authorcbrice
Last Modified ByUS Department of Treasury
File Modified2010-03-23
File Created2010-03-23

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