Supporting Statement A- 1525 NEW Mutilated Coin Redemption Program Application Form

SUPPORTING STATEMENT

UNITED STATES MINT

MUTILATED COIN REDEMPTION PROGRAM INSTRUCTIONS and APPLICATION FORM

NEW OMB INFORMATION COLLECTION

Mint OMB #: 1525-NEW

A. JUSTIFICATION

A1. CIRCUMSTANCES NECESSITATING COLLECTION OF INFORMATION

This is a request for a new information collection for a three year clearance for the United States Mint (U.S. Mint), Mint Form MF 6006, United States Mint Mutilated Coin Redemption Program Instructions and Application Form. The purpose of the U.S. Mint Mutilated Coin Redemption Program Instructions and Application Form is to establish instructions and guidelines that outline the mutilated coin submission process including participant (individuals and companies) application forms, certification and authentication of mutilated US coinage and submission of Standard Form SF 3881, ACH Vendor/Miscellaneous Payment Enrollment for processing electronic transfer of funds for payments. This clearance will allow the U.S. Mint to comply with specific requirements of the Mutilated Coin Redemption Program under the authority of 31 U.S.C. § 5120, Obsolete, Mutilated, and Worn Coins and Currency, which allow individuals and companies to exchange bent and/or partial coins for reimbursement. Department of the Treasury regulations appearing in 31 C.F.R. part 100 subpart C, Request for Examination of Coin for Possible Redemption. Subpart C regulations supporting the program include:

• §100.10 Request for Examination of Uncurrent Coin for Possible Redemption

• §100.11 Request for Examination of Bent or Partial Coin for Possible Redemption

• §100.12 Exchange of Fused or Mixed Coin

• §100.13 Notices

The U.S. Mint produces circulating coins for use by the public. As a public service, for over a century the U.S. Mint has administered a program that permits individuals and companies to redeem mutilated U.S. Mint coinage. The United States Mint Coin Redemption Program Instructions and Application Form, Mint Form, MF 6006 and SF 3881, ACH Vendor/Miscellaneous Payment Enrollment supports performance of customer service by providing a program to redeem mutilated U.S. Mint coins per established guidelines and regulations outlined in the U.S. Mutilated Coin Redemption Program.

The U.S. Mint is seeking a three-year clearance as filed in the Federal Register that will provide time for monitoring the performance of the form and identifying any improvements necessary for the efficient and effective administration of the U.S. Mint Mutilated Coin Redemption Program.

This clearance covers data collection efforts by the United States Mint at Philadelphia and the Mint’s Manufacturing and Finance Directorates in Washington DC. This information collection will provide:.

• Consistency with U.S. Mint mission and strategic objectives for providing exceptional customer service;

• Alignment within the U.S. Mint’s Strategic Plan and/or U.S. Mint annual business plans;

• Minimized burden on the respondent;

• Confidentiality of individual responses;

• Consistency with applicable law and regulation; and

• Voluntary data collection.

A2. USE OF DATA

Individuals and businesses seeking to exchange bent and partial coins for reimbursement will complete and submit 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. The information will be used to review and approve or reject submissions for redeeming U.S. Mint mutilated coins per the guidelines and regulations for the United States Mint Mutilated Coin Redemption Program.

A3. USE OF INFORMATION TECHNOLOGY TO REDUCE BURDEN

U.S. Mint form MF 6006 is a fillable form for completion, printing, and submission with SF Form 3881, ACH Vendor/Miscellaneous Payment Enrollment form. The forms will be available at https://www.usmint.gov/news/consumer-alerts/mutilated-coin-program.

A4. EFFORTS TO IDENTIFY DUPLICATION

U.S. Mint internal review, approval, and rejection process ensures that duplication of data gathering within the U.S. Mint process is eliminated.

A5. METHODS TO MINIMIZE BURDEN ON SMALL BUSINESSES OR OTHER SMALL ENTITIES

This information collection will not have a significant impact on small businesses or small entities.

A6. CONSEQUENCES OF LESS FREQUENT COLLECTION ON FEDERAL PROGRAMS OR POLICY ACTIVITIES

Without the ability to collect the required information for the U.S. Mint Mutilated Coin Redemption Program, the U.S. Mint would have insufficient information to redeem mutilated coins submitted for reimbursement.

A7. SPECIAL CIRCUMSTANCES REQUIRING DATA COLLECTION TO BE INCONSISTENT WITH GUIDELINES IN 5 C.F.R. § 1320.6

No special circumstances require the collection to be conducted in a manner inconsistent with the guidelines in 5 C.F.R. § 1320.6, Public Protection.

A8. CONSULTATION WITH INDIVIDUALS OUTSIDE OF THE AGENCY ON AVAILABILITY OF DATA, FREQUENCY OF COLLECTION, CLARITY OF INSTRUCTIONS AND FORMS, AND DATA ELEMENTS

The U.S. Mint collaborates with the Bureau of the Fiscal Service for the processing of payments for approved submissions for reimbursement based on weight equivalent value of the denominations submitted as mutilated coins.

A9. EXPLANATION OF DECISION TO PROVIDE PAYMENT OR GIFT TO RESPONDENTS

Decision to provide payment is based on compliance with statutory and regulatory requirements, including 31 U.S.C. § 5120 and 31 C.F.R. part 100 subpart C.

A10. ASSURANCE OF CONFIDENTIALITY OF RESPONSES

All information is maintained in a secure environment.

A11. JUSTIFICATION OF SENSITIVE QUESTIONS

Personally identifiable information (PII) is needed to evaluate applications and issue reimbursement payment to requesters seeking reimbursement based on the weight equivalent of the value of the denominations submitted as mutilated U.S. Mint coins. Privacy implications are being addressed through the development of privacy documents, such as a Privacy and Civil Liberties Impact Assessment and System of Records Notice, which are currently in progress.

A12. ESTIMATED BURDEN OF INFORMATION COLLECTION

The estimated annual number of respondents is 200 and estimated annual burden hours is 200.

Collection Instrument	Number of Respondents	Number of Responses per year	Average Burden per Response (in hours)	Average Hourly Wage Rate1	Total Annual Respondent Cost
MF 6006	200	1	200	$37.03	$7,406
Total	200		200		$7,406

A13. ESTIMATED TOTAL ANNUAL COST BURDEN TO RESPONDENTS

There are no start-up or annualized costs to respondents for this information collection. Respondents may mail completed forms to the U.S. Mint. Therefore, we estimate that respondents would incur $1.10 per response for the postage. The total respondent postage costs for this information collection would be $220.00 (200 x $1.10 = $220.00).

A14. ESTIMATED ANNUALIZED COST TO THE FEDERAL GOVERNMENT

There will be no annualized capital/start-up costs for the government to receive this information. The below table reflects the estimated time for a GS-13, Step 1 to review the information collected.

Collection Instrument	Number of Responses	Average Review Time per Response (in hours)	Total Time to Review (in hours)	Average Hourly Wage Rate2	Total Annual Government Cost
Mutilated Coin Redemption Program Form	200	0.25 hours (15 minutes)	50	$71.54	$3,577.00
TOTAL	200		50		$3,577.00

A15. REASONS FOR CHANGE IN BURDEN

This is a new information collection.

A16. PLANS FOR TABULATION, STATISTICAL ANALYSIS AND PUBLICATION

Information from data collections will not be published for statistical purposes.

A17. REASONS WHY DISPLAYING THE OMB EXPIRATION DATE IS INAPPROPRIATE

The OMB expiration date will be displayed on the U.S. Mint Coin Redemption Program Instruction and Application Form.

A18. EXCEPTIONS TO THE CERTIFICATION STATEMENT ON OMB

FORM 83-I

Not applicable. There are no exceptions for certifications.

1 It is expected that respondents to this collection could be from any occupation. The 2019 average wage rate for all occupations is $25.72. This is sourced from the Bureau of Labor Statistics website: https://www.bls.gov/oes/current/oes_nat.htm A benefit multiplier of 1.44 is used to calculate a fully-loaded wage rate of $37.03 ($25.72 x 1.44= $37.03)

Using the BLS Employer Costs for Employee Compensation – March 2020 report https://www.bls.gov/news.release/pdf/ecec.pdf, a benefit multiplier of 1.44 was calculated by taking the private industry worker 50^th (median) wage percentile total compensation rate divided by the wages and salaries rate. $26/$18.05=1.44

2 The 2021 wage rate for a GS-13, Step 1 is $49.68. This is sourced from the Office of Personnel Management (OPM) website: https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2021/DCB_h.pdf

A benefit multiplier of 1.44 is used to calculate a fully-loaded wage rate of $71.54 ($49.68 x 1.44= $71.54)

Using the BLS Employer Costs for Employee Compensation – March 2020 report https://www.bls.gov/news.release/pdf/ecec.pdf, a benefit multiplier of 1.44 was calculated by taking the private industry worker 50^th (median) wage percentile total compensation rate divided by the wages and salaries rate. $26/$18.05=1.44