Ss_1510-0035_jul2013

SS_1510-0035_JUL2013.doc

Assignment Form

OMB: 1530-0011

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Supporting Statement FOR

Paperwork Reduction Act SubmissionS

OMB No. 1510-0035

Assignment Form


  1. Justifications.


  1. Explain the circumstances that make the collection of information necessary.


Under the International Claims Settlement Act of 1949, as amended, the War Claims Act of 1928, as amended, and the War Claims Act of 1948, the Department of the Treasury has the responsibility of making payments on awards and on divested accounts from funds made available for these purposes.


  1. Indicate how, by whom, and for what purpose the information is to be used.


The Assignment Form is used by an award holder who wishes to assign or transfer all or part of his award to another person. In assigning the award, the award holder forfeits his rights to the portion assigned and the assignee becomes the owner of that portion. This form is often used to assign a portion to a lawyer to cover attorney’s fees.


  1. 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.


No consideration is being made at the present time to use any form of automated or any form of information technology in this program area. There are no technical obligations impending reductions in burden.


  1. Describe efforts to identify duplication.


The Judgment Fund Branch is the only office making payments under the International Claims Settlement Act of 1949, the War Claims Act of 1928, and the War Claims Act of 1948. Since no other office is involved in processing payments for these awards, duplication of this information collection should not occur.


  1. If the collection of information impacts small businesses or other small entities, describe any methods used to minimize burden.


This information does not involve small businesses.


  1. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently.


There would be no consequences to Federal program or policy activities trying to change the frequency of collection. This collection of information is requested on an as needed basis, whenever an award holder wishes to assign a portion of his award to someone else.


  1. Explain any special circumstances that would require data collection to be inconsistent with guidelines in 5 CFR 1320.5(d)(2).


There are no special circumstances that requires the collection to be conducted in a manner inconsistent with 5 CFR 1320.5(d)(2).


  1. Consultation with individuals outside of the Agency on availability of data, frequency of collection, clarity of instructions and forms, and data elements.


A 60-day notice was published in the Federal Register on May 31, 2013, at 78 FR 32710 soliciting comments. No comments were received regarding this information collection.


  1. Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.


There are no gifts or payments to respondents associated with this information collection.


  1. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation, or agency policy.


An assurance of confidentiality is not required.

  1. Provide additional justification for any questions of a sensitive nature.


There are no sensitive questions in the information collection.


  1. Provide estimates of the hour burden of the collection of information.


No. of Respondents

No. of Responses Per Respondent

No. Annual Responses

Hours Per Response

Total Annual Burden

150

1

150

0.50

75


This was based on a combination of factors: a) Past experience working with the respondents who have come to the office for assistance in completing the form; b) Running tests with employees in the office to see how long it took to complete the form, and c) An estimate of the time it would take the respondents to have a corporate seal placed on the form similar to notarization.


  1. Provide an estimate for the total annual cost burden to respondents or record keepers resulting from the collection of information.


There is no annual cost to respondent. The respondent would complete the form (fillable/signable PDF) and send it in. There are no start up costs of operational and maintenance costs. The only cost the respondent may incur would be cost of postage to mail in the form.


  1. Provide estimates of annualized costs to the Federal government.


Annualized cost to the Federal Government is includes mailing and printing costs, review and verifying information is estimated to be $2,294.


  1. Explain the reasons for any program changes or adjustments.


There are no changes in the burden hours. This request is for renewal purposes only.


  1. Plans for tabulation, statistical analysis and publication.


The results of this information collection will not be published for statistical purpose.


  1. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.


Non-display of OMB expiration date would eliminate any confusion by the respondent when the form is required by the bureau and the need to revise the form with each renewal when no other changes to the form have occurred.


  1. Explain each exception to the certification statement on OMB Form 83-I.


Not applicable, there are no exceptions.



  1. Collections of Information Employing Statistical Methods


This information collection does not employ statistical methods.

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File Typeapplication/msword
File TitleSUPPORTING STATEMENT
Authorcbrice
Last Modified ByWolfgang, Dawn
File Modified2013-07-31
File Created2013-07-29

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