Information Collection

Application for disposition of Retirement Plan/Individual Retirement Bonds Without Admin. of Deceased Owners Estate

IC 16523 under ICR 201205-1535-002 · OMB 1535-0032.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PD F 3565 Application for disposition of Retirement Plan/Individual Retirement Bonds Without Admin. of Deceased Owners Estate	Form and Instruction
PD F 3565 Application For Disposition Of Retirement Plan And/Or In sav3565.pdf www.treasurydirect.gov/forms/sav3565.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 31 CFR 346.9

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PD F 3565	Application For Disposition Of Retirement Plan And/Or Individual Retirement Bonds Without Administration Of Deceased Owner's Estate	sav3565.pdf	http://www.treasurydirect.gov/forms/sav3565.pdf	Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	350	300	50
Annual IC Time Burden (Hours)	117	100	17
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.