Information Collection

EFT Waiver Form - DFAS

IC 211679 under ICR 201507-1530-002 · OMB 1530-0019.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1530-0019 can be found here:

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 FS_Form_1201WDFAS.pdf	Form and Instruction

IC Title:

EFT Waiver Form - DFAS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	FS_Form_1201WDFAS.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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	250	0	250
Annual IC Time Burden (Hours)	83	0	83
Annual IC Cost Burden (Dollars)	123	123	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.