FMS-1133 (Electronic Pre-Printed Information), Claim Against the United States for the Proceeds of a Government Check

(Electronic Pre-Printed Information), Claim Against the United States for the Proceeds of a Government Check

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1510-0019 can be found here:

Documents and Forms

Document Name Document Type
Form FMS 1133 FMS-1133 (Electronic Pre-Printed Information), Claim Against the United States for the Proceeds of a Government Check Form and Instruction
FMS 1133 Claim Against the United States for the Proceeds of a Go ROCISForm 1133.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	FMS-1133 (Electronic Pre-Printed Information), Claim Against the United States for the Proceeds of a Government Check	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FMS 1133	Claim Against the United States for the Proceeds of a Government Check	ROCISForm 1133.pdf		No		Paper Only

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 67,649	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	67,649	14,775	52,874
Annual IC Time Burden (Hours)	11,278	2,464	8,814
Annual IC Cost Burden (Dollars)	0	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.