Direct Deposit Sign-Up Form and Go Direct Sign Up Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FMS form 1201S Direct Express Enrollment Form SSA SSI	Form and Instruction	Modified	Available
Form FMS form 1201L Direct Express Enrollment Form	Form and Instruction	Modified	Available
Form FMS 1200 VADE Direct Express	Form and Instruction	Modified	Available
Form FMS 1200 Go Direct Sign Up Form (Spanish)	Form and Instruction	Modified	Available
Form FMS 1200 Go Direct Sign Up Form for Direct Deposit of Federal Benefit Payments	Form and Instruction	Modified	Available
Form SF-1199A Direct Deposit Sign Up Form	Form and Instruction	Modified	Available
SS_1510-0007_JUL2013.doc	Supporting Statement A	Uploaded 2013-07-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
39066	Direct Deposit Sign-Up Forms	Form and Instruction	Modified	Direct Express Enrollment Form SSA SSI
39066	Direct Deposit Sign-Up Forms	Form and Instruction	Modified	Direct Express Enrollment Form
39066	Direct Deposit Sign-Up Forms	Form and Instruction	Modified	Direct Express
39066	Direct Deposit Sign-Up Forms	Form and Instruction	Modified	Go Direct Sign Up Form (Spanish)
39066	Direct Deposit Sign-Up Forms	Form and Instruction	Modified	Go Direct Sign Up Form for Direct Deposit of Federal Benefit Payments
39066	Direct Deposit Sign-Up Forms	Form and Instruction	Modified	Direct Deposit Sign Up Form

ICR Details

OMB Control No: 1510-0007	ICR Reference No: 201307-1510-001
Status: Historical Active	Previous ICR Reference No: 201109-1510-001
Agency/Subagency: TREAS/FMS	Agency Tracking No:
Title: Direct Deposit Sign-Up Form and Go Direct Sign Up Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/24/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/31/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2016	36 Months From Approved	10/31/2013
Responses	406,715	0	406,715
Time Burden (Hours)	67,786	0	69,142
Cost Burden (Dollars)	0	0	0

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Abstract: The Direct Deposit Sign-Up Form is used by recipients to authorize the deposit of Federal payments into their accounts at financial institutions. The information is used to route the Direct Deposit payment to the correct account at the correct financial institution. It identifies persons who have executed the form.

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Authorizing Statute(s): US Code: 12 USC 391 Name of Law: Banks and Banking;Federal reserve banks as Government depositaries and fiscal agents
   US Code: 5 USC 301 Name of Law: GOVERNMENT ORGANIZATION AND EMPLOYEES; Departmental regulations
   US Code: 31 USC 492 Name of Law: MONEY AND FINANCE
  

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
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 32533	05/30/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 46001	07/30/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Direct Deposit Sign-Up Forms	FMS 1200 VADE, SF-1199A, FMS 1200, FMS 1200 , FMS form 1201L, FMS form 1201S	Direct Deposit Sign Up Form ,   Go Direct Sign Up Form for Direct Deposit of Federal Benefit Payments ,   Go Direct Sign Up Form (Spanish) ,   Direct Express ,   Direct Express Enrollment Form ,   Direct Express Enrollment Form SSA SSI

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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	406,715	406,715	0	0	0	0
Annual Time Burden (Hours)	67,786	69,142	0	0	-1,356	0
Annual Cost Burden (Dollars)	0	0	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: A recalculation of response time resulted in a slight decrease of 1,356 burden hours due to an adjustment in our estimates.

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Annual Cost to Federal Government: $384,345

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: 07/31/2013

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