Request for Payment of Reissue of U.S. Savings Bonds Deposited in Safekeeping

Forms and Documents

Document Name	Status
Form FS Form 4239 Request for payment or reissue of U.S. Savings Bonds deposited in Safekeeping Form and Instruction	Modified
Supporting Statement_1530-0024.doc Supporting Statement A	2016-03-17

IC Document Collections

IC ID	Document Title	Status
16558	Request for payment or reissue of U.S. Savings Bonds deposited in Safekeeping Form and Instruction	Modified

ICR Details

OMB Control No: 1530-0024	ICR Reference No: 201603-1530-001
Status: Historical Active	Previous ICR Reference No: 201407-1530-026
Agency/Subagency: TREAS/FISCAL	Agency Tracking No:
Title: Request for Payment of Reissue of U.S. Savings Bonds Deposited in Safekeeping
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/03/2016
	Date Received in OIRA: 03/31/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved	06/30/2016
Responses	1,400	0	9,000
Time Burden (Hours)	233	0	1,500
Cost Burden (Dollars)	0	0	0

---

Abstract: The information is necessary to request payment or reissue of Savings Bonds/Notes held in safekeeping when original safekeeping custody receipts are not available. The information on the form is used by the Department of the Treasury, Bureau of the Fiscal Service, to identify the securities involved, establish entitlement, and to obtain a certified request for payment or reissue. Without the information, the transaction cannot be completed.

---

Authorizing Statute(s): US Code: 31 USC Part 353 Name of Law: null
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 81437	12/29/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 18694	03/31/2016
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Request for payment or reissue of U.S. Savings Bonds deposited in Safekeeping	FS Form 4239	REQUEST BY OWNER OR PERSON ENTITLED TO PAYMENT OR REISSUE OF UNITED STATES SAVINGS BONDS/NOTES DEPOSITED IN SAFEKEEPING WHEN ORIGINAL CUSTODY RECEIPTS ARE NOT AVAILABLE

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,400	9,000	0	0	-7,600	0
Annual Time Burden (Hours)	233	1,500	0	0	-1,267	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The decrease to the reported burden is due to an examination of forms distributed by the Bureau of the Fiscal Service or downloaded from the TreasuryDirect website since the last renewal cycle. Since December 2012, Series EE and I Savings Bonds are only available in electronic form unless a Series I Bond is purchased with a tax refund. The amount of bonds deposited for safekeeping is proportionate to the reduced amount of paper bonds issued, thus leading to a decrease in the respondents using FS Form 4239.The decrease of 1267 hours is an adjustment in agency estimate for a total of 233 burden hours requested.

---

Annual Cost to Federal Government: $2,670

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/31/2016

---