Mutilated Coin Redemption Program

Forms and Documents

Document Name	Status
Form SF 3881 United States Mint Mutilated Coin Redemption Program Instructions and Application Form Form and Instruction	New
Proposed Rule - Exchange of Coin.pdf Supplementary Document	2021-05-07
Supporting Statement A- 1525 NEW Mutilated Coin Redemption Program Application Form.docx Supporting Statement A	2021-05-07

IC Document Collections

IC ID	Document Title	Status
247220	United States Mint Mutilated Coin Redemption Program Instructions and Application Form Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202105-1525-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: TREAS/MINT	Agency Tracking No:
Title: Mutilated Coin Redemption Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/07/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	200	0
Time Burden (Hours)	200	0
Cost Burden (Dollars)	220	0

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Abstract: The data collection method employed is completion and submission of U.S. Mint form, MF 6006, Mutilated Coin Redemption Program Instructions and Application Form and SF Form 3881, ACH Vendor/Miscellaneous Payment Enrollment to apply to redeem mutilated U.S. Mint coinage submitted.

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Authorizing Statute(s): US Code: 31 USC 5120 Name of Law: Obsolete, Mutilated, and Worn Coins and Currency
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1525-ZA01	Proposed rulemaking	86 FR 23877	05/05/2021

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
United States Mint Mutilated Coin Redemption Program Instructions and Application Form	SF 3881, MF 6006	ACH Vender Miscellaneous Payment Enrollment Form ,   Mutilated Coin Redemption Program Instructions and Application Form

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ICR Summary of Burden

	Total Request	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	200	0	0	200	0	0
Annual Time Burden (Hours)	200	0	0	200	0	0
Annual Cost Burden (Dollars)	220	0	0	220	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: This is a new collection.

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Annual Cost to Federal Government: $3,577

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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? No

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Common Form ICR:  No

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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: 05/07/2021

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