Form FR 3063b FR 3063b GOVERNMENT-ISSUED, GENERAL-USE PREPAID CARD SURVEY Gover

FR 3063b
OMB No. 7100-0343
Approval expires December 31, 2014

GOVERNMENT-ISSUED, GENERAL-USE
PREPAID CARD SURVEY
Government Survey

Survey Period:
Calendar Year 2011

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General Instructions
About this Survey
The Board is required to report annually to the Congress on the prevalence of the use of general-use
prepaid cards in federal, state, or local government-administered payment programs, and the interchange
fees and cardholder fees charged with respect to the use of such general-use prepaid cards. [15 U.S.C.
1693o-2] The information requested in this survey will be used as input to this report.
Your Participation
To achieve the most reliable results, it is important that you respond completely and accurately. Please
leave no survey item blank.
The survey should be completed in aggregate for all programs and for each program individually
administered within your jurisdiction. Sections II through IV should be repeated as many times as needed
to provide the requested data on each program.
There are three possible ways to answer a survey question:
Enter a Value: The actual numeric value of the data element.
Enter a Zero: When the calculated value equals zero. Please do not enter a non-numeric
value, e.g. “NA” or “NR,” when the value equals zero.
Enter “NR” (Not Reported): If your government agency engages in the activity of the type being
measured but you are unable to report a figure that reflects that activity.
Please do not enter “NA.”
If for any reason you cannot provide complete data or you have questions please contact
Jennifer Williams at 202-452-2446 or e-mail [email protected] for assistance.
The survey will be made available online at
https://www.federalreserve.gov/debitcardsurveys.
Please complete the survey by April 16, 2012.
Response Confidentiality and Burden
The Federal Reserve Board does not regard the individual organization information provided by each
respondent as confidential.
Public reporting burden for this collection of information is estimated to be 15 hours per response,
including the time to gather data in the required form and to review instructions and complete the
information collection. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing the burden, to Secretary, Board of Governors
of the Federal Reserve System, 20th and C Streets, N.W., Washington, D.C. 20551, or via email to
[email protected]; and to the Office of Management and Budget, Paperwork Reduction Project
(7100-to be assigned), Washington, D.C. 20503. The Federal Reserve may not conduct or sponsor, and
an organization (or a person) is not required to respond to, a collection of information unless it displays a
currently valid OMB control number.

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Section I:

Respondent Information

1. Name of government agency/agencies covered in this response

2. Contact person(s) by section of the survey for which responsible
Name

Email

Section

Phone

Name

Email

Section

Phone

Name

Email

Section

Phone

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Section II:

Government-Administered, General-Use
Prepaid Card Program Information

Please enter totals only for programs related to general-use prepaid cards linked to U.S.-domiciled accounts
involving a merchant located in the United States during the calendar year (CY) 2011.
Provide totals in every section aggregating all programs covered by this agency. Then repeat sections II
through IV (as many times as needed) to provide totals for each individual program that your agency
administers (as listed in Question 1 below).
Include:

All general-use prepaid card programs administered by a federal, state, or local government
agency. Examples of such general-use card programs include, but are not limited to, federal benefit
programs (such as Social Security Administration, Supplemental Security Income, and Veterans
Administration), electronic benefit transfer programs (such as the Supplemental Nutrition Assistance
Program (SNAP)), cash assistance programs (such as Temporary Assistance to Needy Families and
the Heating and Energy Assistance Program), payroll programs, child support programs,
reimbursement programs, disaster relief programs, and petty cash programs.

Specific instructions for Section II when reporting in aggregate:
List the name of each individual program covered in 1.
Check all programs that apply in 2.
List all relevant jurisdictions in 3.
List all relevant sponsoring government agencies that apply in 4.
List all relevant card-issuing banks in 5.
Provide a description of each payment program covered in 6.
Report the total number of recipients receiving prepaid card payments for all programs in 7. and specify
all relevant categories of recipients.
Report the total number of recipients receiving payments (all payment methods, e.g., check, automated
clearing house, general-use prepaid card) for all programs in 8.

1. Name of government-administered payment program(s) covered in this response

Federal
[ ]

2. Does this response cover federal, state, or
local program(s)?

State
[ ]

Local
[ ]

For reporting totals for an individual program, check
only one.

3. Jurisdiction(s)
Geographic area in which the government-administered, general-use prepaid cards have been issued (e.g.
nationally, specific state(s), county/counties, municipality/municipalities).

4. Sponsoring government agency/agencies
Government agency administering the general-use prepaid card program

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5. Card-issuing bank(s)

6. Description of government-administered payment program
Please provide the type of program (e.g. medical benefit, unemployment insurance, child support, SNAP, inkind assistance).

Number
7. Recipients receiving payments on governmentadministered, general-use prepaid cards as of
December 31, 2011
Count each card, individual, household, or other category only
once.

Individual
[ ]

Please specify how recipients are counted:
For reporting totals for an individual program, check
only one.

Household
[ ]

Other
[ ]

If other, please specify:

Number
8. All Recipients receiving payments (all payment
methods, e.g., check, automated clearing house, generaluse prepaid card) as of December 31, 2011

Section III:

Government-Administered Payment Cards
Number

1. Government-administered, general-use prepaid
cards outstanding as of December 31, 2011
1a.

Government-administered, general-use prepaid cards
on which cardholders receive benefits or
payments from multiple programs as of
December 31, 2011
Please list all programs covered within this response for which 1a. applies:

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Section IV:

Funding

Value ($)

1. Funds loaded onto government-administered,
general-use prepaid cards in 2011
2. All funds paid (all payment methods, e.g., check,
automated clearing house, general-use prepaid card) in
2011

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Glossary of Terms
Government-administered payment program: A program is considered governmentadministered regardless of whether a federal, state, or local government agency operates the
program or outsources some or all functions to third parties so long as the program is operated on
behalf of the government agency. In addition, a program may be government-administered even if a
federal, state, or local government agency is not the source of funds for the program it administers.
For example, child support programs are government-administered programs even though a federal,
state, or local government agency is not the source of the funds. In addition, to the extent Health
Savings Accounts, Flexible Spending Accounts, and Health Reimbursement Arrangement accounts
are offered in connection with a person's employment and administered by or on behalf of a
government employer, such accounts are considered government-administered payment programs.
Jury duty payment programs administered by federal, state, or local governments, including courts,
are also considered government-administered payment programs. Further, local governmentadministered payment programs would include programs administered by tribal governments.
General-use prepaid card: A card or other payment code or device that is (1) issued on a prepaid
basis in a specified amount, whether or not that amount may be increased or reloaded, in exchange
for payment and (2) redeemable upon presentation at multiple unaffiliated merchants for goods or
services. For the purposes of this survey, this definition applies to card programs, which include, but
are not limited to, federal benefits (such as Social Security Administration, Supplemental Security
Income, and Veterans Administration), electronic benefit transfer (such as SNAP), cash assistance
(such as Temporary Assistance to Needy Families and the Heating and Energy Assistance Program),
payroll, child support, reimbursements, disaster relief, and petty cash. In addition, the funds related
to these card programs may be loaded directly onto the card, into an account associated with the
card, or set aside in some other manner for the benefit of the cardholder.
Jurisdiction: Geographic area in which government-administered, general-use prepaid cards have
been issued (such as nationally, specific state, county, or municipality).
United States: The states, territories, and possessions of the U.S., the District of Columbia, the
Commonwealth of Puerto Rico, or any political subdivision of any of the foregoing.

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