Information Collection

Special Form of Request for Payment of U.S. Savings and Retirement Sec. Where Use of a Detached Request is Authorized

IC 43842 under ICR 201207-1535-002 · OMB 1535-0004.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PD F 1522 E Special Form of Request for Payment of U.S. Savings and Retirement Sec. Where Use of a Detached Request is Authorized	Form and Instruction
PD F 1522 E Special Form Of Request For Payment Of United States Sav sav1522.pdf www.treasurydirect.gov/forms/sav1522.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:

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 1522 E	Special Form Of Request For Payment Of United States Savings And Retirement Securities Where Use Of A Detached Request Is Authorized	sav1522.pdf	http://www.treasurydirect.gov/forms/sav1522.pdf	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56,000

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	Previously Approved
Annual Number of Responses for this IC	56,000	56,000
Annual IC Time Burden (Hours)	14,000	14,000
Annual IC Cost Burden (Dollars)	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.