Information Collection

Claims Against the U.S. for Amounts Due in Case of a Deceased Creditor

IC 15402 under ICR 201407-1530-004 · OMB 1530-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1530-0004 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF 1055 Claims Against the U.S. for Amounts Due in Case of a Deceased Creditor	Form and Instruction
SF 1055 Claim Against the United States for Amounts Due in the C SF 1055_FMS.pdf	Form and Instruction

IC Title:

Claims Against the U.S. for Amounts Due in Case of a Deceased Creditor

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	SF 1055	Claim Against the United States for Amounts Due in the Case of a Deceased Creditor	SF 1055_FMS.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

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	400	400
Annual IC Time Burden (Hours)	180	180
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.