Owner's Affidavit of Partial Destruction of Mutilated Currency

Documents and Forms

Document Name Document Type
Form BEP 5283 Owner's Affidavit of Partial Destruction of Mutilated Currency Form and Instruction
BEP 5283 Owner's Affidavit of Partial Destruction of Mutilated Cu BEP5283_REV10-07.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Owner's Affidavit of Partial Destruction of Mutilated Currency	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	BEP 5283	Owner's Affidavit of Partial Destruction of Mutilated Currency	BEP5283_REV10-07.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	90	90
Annual IC Cost Burden (Dollars)	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.