January 30, 2014
Supporting Statement
Explain the circumstances that make this collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Information on the form provides proof of the authority of the officer(s) named by title or by name and title, to act on behalf of an organization in its name in one or more of the following ways: (1) assign, sell or dispose of Treasury securities held by the organization, (2) assign, sell or dispose of Treasury securities held by the organization in a fiduciary capacity, or (3) execute and deliver contractual agreements for replacement of lost, stolen, or destroyed Treasury securities on behalf of the organization as surety principal or both.
Indicate how, by whom and for what purpose is this information used? The information permits the Bureau of the Fiscal Service to recognize the officer(s) named on the form, which is used as a copy of a resolution passed by the organization's governing body to carry out the specific requirements. The form serves as a certified copy of a resolution. The form is used only by those organizations that would like to delegate authority to certain officer(s) to dispose of Treasury securities that either are owned by the organization or are held by it in a fiduciary capacity. Without the provision of this form and the collection of this information, corporations and organizations would, in some cases, be greatly inconvenienced.
Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology? What consideration is given to use information technology to reduce burden?
The form is available from the Bureau of the Fiscal Service and also on the Internet as a fill-in PDF form.
Describe efforts are used to identity duplication? Why can’t any similar information already available be used or modified for use for the purposes described in Item 2 above?
Duplicate information is not requested.
If this collection of information impacts small businesses or other small entities, what methods are used to minimize burden?
This collection of information does not impact small business or other small entities.
What consequences to Federal program or policy activities and what, if any, technical or legal obstacles to reducing burden will occur if this collection is not conducted or is conducted less frequently?
The collection of information cannot be conducted less frequently because the collection is initiated for a single purpose.
Is this collection of information conducted in a manner consistent with the guidelines of 5 CFR 1320.6?
This information collection is consistent with 5 CFR 1320.6
What effort was made to notify the general public about this collection of information?
The Bureau’s notice was published in the Federal Register on November 27, 2013, Page 71038. No comments were received.
What decision was made to provide any payment or gift to respondents, other than re-enumeration of contractors or grantees? N/A
What assurance of confidentiality was provided to respondents and what was the basis for the assurance in statute, regulations, or agency policy?
Aside from protections contained in the Privacy Act, there is no guarantee of confidentiality.
What justification is there for questions of a sensitive nature? There are no questions of a sensitive nature.
Whether the information collection includes Personally Identifiable Information (PII) and what this PII is.
The following list describes the Personally Identifiable Information (PII) included in this collection and the purpose of gathering this information.
Type |
Intended Use |
Individual Name |
Identify qualified individuals to act on behalf of an organization. |
Individual Title |
Identify the title held by qualified individuals acting on behalf of an organization. |
OMB memo M-07-16 (Safeguarding Against and Responding to the Breach of Personally Identifiable Information) requires agencies to take steps to eliminate unnecessary use of SSNs and explore alternatives to the use of SSNs as a personal identifier. Agencies must explain why the collection and use of SSNs is necessary, why alternative identifiers will not suffice, and how the agency complies with the requirements in section 7 of the Privacy Act. If this PII includes SSNs, did the agency inform individuals whether the disclosure is mandatory or voluntary? What statute, or other authority, is the SSN being solicited under? How will the SSN be used?
Furnishing of a SSN is not required in this collection.
A citation to any applicable SORN for the collection of PII. If the agency has not yet published or received approval for this SORN, where in the process is the SORN (about to be published, submitted to OMB for approval, etc)?
System of Records Name: Treasury/BPD.002 – United States Savings-Type Securities, Published August 17, 2011
Please cite the website where any applicable Privacy Impact Assessment (PIA) is published.
TreasuryDirect (https://www.treasurydirect.gov/TreasuryDirectPrivacyImpactAssessment.pdf).
What is the estimated hour burden of this collection of information?
The average time needed is 10 minutes per response multiplied by the estimated number of responses (2,580) reflects the total burden of 430 hours.
What is the estimated total annual cost burden to respondents or record-keepers resulting from this collection of information?
Estimated cost burden to respondents is not available at this time.
What is the annualized cost to the Federal Government?
The following factors were used to estimate the annual burden to this agency:
Printing cost - estimated number of forms printed annually, multiplied by the unit cost of the forms.
Case processing cost - estimated number of forms completed, multiplied by a percentage of the unit cost of case processing.
Forms management cost - salary cost of forms management personnel.
Printing Cost 2,580 @ $0.04 = $ 103.20
Case processing cost 2,580 @ $1.50/form = $ 3,870.00
Forms Management Cost = $ 500.00
Total Cost = $ 4,473.20
What is the reason for any program changes or adjustments reported in Items 13 or 14 of the OMB Form 83-I?
The reported burden increase is a result of an examination of actual usage since the previous renewal package when the form was combined with a form used for similar purposes. The increase of 1,200 hours is an adjustment in agency estimate for a total of 2,580 hours.
For collections of information whose results will be published, outline plans for tabulation and publication.
The results of the collection of this information will not be published for statistical use.
If seeking approval to not display the expiration date for OMB approval of this information collection, what are the reasons that the display would be inappropriate?
The public interest will be better served by not displaying an expiration date on this form. The time period during which the current edition of the form will continue to be usable cannot be predicted. It could easily span several cycles of review and OMB clearance renewal. Displaying the expiration date would make it necessary to update the electronic form and website where it is accessed after each renewal. Additionally, not displaying the expiration date on the form will avoid confusion among members of the public who may have identical forms with different expiration dates in their possession. By not displaying the expiration date, supplies of the form could continue to be used regardless of when the OMB approval has expired. This would reduce costs incurred through additional printing and desktop publishing.
What are the exceptions to the certification statement? N/A
| File Type | application/msword |
| Author | ARC |
| Last Modified By | Wolfgang, Dawn |
| File Modified | 2014-03-17 |
| File Created | 2014-03-17 |