Information Collection

Report/Appl. for relief of loss, theft, destruction of U.S. Bearer Securities

IC 43846 under ICR 201511-1530-005 · OMB 1530-0033.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1530-0033 can be found here:

Documents and Forms

Document Name Document Type
Form FS Form 1022-1 Report/Appl. for relief of loss, theft, destruction of U.S. Bearer Securities Form and Instruction
FS Form 1022-1 Report/Application for Relief on Account of Loss, Theft sec1022-1.pdf www.treasurydirect.gov/forms/sec1022-1.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Report/Appl. for relief of loss, theft, destruction of U.S. Bearer Securities	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FS Form 1022-1	Report/Application for Relief on Account of Loss, Theft or Destruction of U.S. Bearer Securities (Individuals)	sec1022-1.pdf	http://www.treasurydirect.gov/forms/sec1022-1.pdf	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	92	92
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.