Information Collection

Request for payment or reissue of U.S. Savings Bonds deposited in Safekeeping

IC 16558 under ICR 201210-1535-003 · OMB 1535-0063.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PD F 4239 Request for payment or reissue of U.S. Savings Bonds deposited in Safekeeping	Form and Instruction
PD F 4239 Request By Owner or Person Entitled to Payment or Reissu sav4239.pdf www.treasurydirect.gov/forms/sav4239.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 4239	Request By Owner or Person Entitled to Payment or Reissue of United States Savings Bonds/Notes Deposited in Safekeeping When Original Custody Receipts Are Not Available	sav4239.pdf	http://www.treasurydirect.gov/forms/sav4239.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: 9,000

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	9,000	8,800	200
Annual IC Time Burden (Hours)	1,500	1,466	34
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.