Information Collection

Pre-Authorized Debit Account (PDA) Brochure and Application

IC 22220 under ICR 202103-1845-001 · OMB 1845-0025.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1845-0025 can be found here:

Documents and Forms

Document Name Document Type
Pre-Authorized Debit Account (PDA) Brochure and Application Form and Instruction
Pre-Authorized Debit Account (PDA) Brochure and Applicat 1845-0025 FSA PDA App 2021 60D.docx Form and Instruction
Pre-Authorized Debit Account (PDA) Brochure and Applicat 1845-0025 FSA PDA App 2021 60D.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Pre-Authorized Debit Account (PDA) Brochure and Application	Agency IC Tracking Number:	ED-2021-SCC-0047

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	NA	Pre-Authorized Debit Account (PDA) Brochure and Application	1845-0025 FSA PDA App 2021 60D.docx		No		Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: Title IV Program Files	FR Citation: 71 FR 3503

Number of Respondents: 1,667	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	1,667	1,667
Annual IC Time Burden (Hours)	138	138
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.