Direct Deposit Enrollment/Change

ICR 201104-2900-015

OMB: 2900-0665

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Unchanged
Supporting Statement A
2011-07-28
IC Document Collections
IC ID
Document
Title
Status
28943 Unchanged
ICR Details
2900-0665 201104-2900-015
Historical Active 200910-2900-005
VA 2900-0665
Direct Deposit Enrollment/Change
Extension without change of a currently approved collection   No
Regular
Approved without change 01/16/2012
Retrieve Notice of Action (NOA) 07/28/2011
  Inventory as of this Action Requested Previously Approved
01/31/2015 36 Months From Approved 01/31/2012
30,000 0 30,000
10,000 0 10,000
0 0 0

This form is designed for use by the insured or beneficiary to establish his/her eligibility for direct deposit. The information is authorized by Public Law 104-134.

PL: Pub.L. 104 - 134 3720C Name of Law: Debt Collection Improvement Account
  
None

Not associated with rulemaking

  76 FR 96 05/18/2011
76 FR 141 07/22/2011
No

1
IC Title Form No. Form Name
Direct Deposit Enrollment/Change 29-0309 Direct Deposit Enrollment/Change

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 30,000 30,000 0 0 0 0
Annual Time Burden (Hours) 10,000 10,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$141,000
No
No
No
No
No
Uncollected
Denise McLamb 202-565-8374 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/28/2011


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