Financial Institution Data Match

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Financial Data Match Tape	Form and Instruction	Modified	Available
Form 1 Election Form	Form and Instruction	Modified	Available
MSFIDM Election Form 2010 PRA_08 03 10_revised 07 25 11.doc	Supplementary Document	Uploaded 2011-08-19	Available
Justification for Non-substnative change 8-2011.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2011-08-15	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
197583	Electronic Transmission Financial Data Match Result File		Modified
182145	Financial Data Match Tape	Form and Instruction	Modified
10015	Election Form	Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0196	ICR Reference No: 201108-0970-005
Status: Historical Active	Previous ICR Reference No: 201011-0970-002
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Financial Institution Data Match
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/14/2011
	Date Received in OIRA: 08/22/2011
Terms of Clearance: Prior terms of clearance remain in effect: OMB clears with the understanding that the agency will submit a revision request for review if it decides to require electronic data exchange, which is currently optional.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2014	05/31/2014	05/31/2014
Responses	1,362	0	1,362
Time Burden (Hours)	403	0	403
Cost Burden (Dollars)	424,519	0	424,519

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Abstract: Section 466(a)(17) of the Social Security Act (the Act), requires states to establish procedures under which the state child support enforcement (IV-D) agency shall enter into agreements with financial institutions doing business in the state for the purpose of securing information leading to the enforcement of child support orders. Under 452(1) of the Act, financial institutions doing business in multiple states may comply by centrally matching through the Federal Parent Locator Service rather than matching in each state in which the financial institution conducts business.

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Authorizing Statute(s): US Code: 42 USC 666(a)(17) Name of Law: Financial Institution Data Match
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Election Form	1	Election Form
Financial Data Match Tape	1	Data Match Results Specification
Electronic Transmission Financial Data Match Result File

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ICR Summary of Burden

table that charts list of burden

	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	1,362	1,362	0	0	0	0
Annual Time Burden (Hours)	403	403	0	0	0	0
Annual Cost Burden (Dollars)	424,519	424,519	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $207,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/22/2011

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