Information Collection

EFT Waiver Form - DFAS

IC 211679 under ICR 201405-1510-002 · OMB 1510-0077.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FS Form 1201W-DFAS EFT Waiver Form - DFAS	Form and Instruction
FS Form 1201W-DFAS Request for Payment by Federal Benefits Check Form_1201WDFAS_Benefit_By_Check_May_2014rev.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	FS Form 1201W-DFAS	Request for Payment by Federal Benefits Check	Form_1201WDFAS_Benefit_By_Check_May_2014rev.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: Direct Deposit Enrollment Records-Treasury/FMS .006

FR Citation: 76 FR 42765

Number of Respondents: 250

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	83	83
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.