Information Collection

Authorization to Disclose Information Related To Stored Value Account

IC 223474 under ICR 201609-1530-001 · OMB 1530-0013.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1530-0013 can be found here:

Documents and Forms

Document Name Document Type
Form FS Form 5752 Authorization to Disclose Information Related To Stored Value Account Form and Instruction
FS Form 5752 Authorization to Disclose Information Related to Stored FS Form 5752.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Authorization to Disclose Information Related To Stored Value Account	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

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 5752	Authorization to Disclose Information Related to Stored Value Account	FS Form 5752.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title: Collections Records-Treasury/FMS.017	FR Citation: 77 FR 62602

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	1	1
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.