Waiver/Remission of Indebtedness Application

ICR 202107-0730-001

OMB: 0730-0009

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2021-07-20
Supplementary Document
2021-07-20
IC Document Collections
ICR Details
0730-0009 202107-0730-001
Received in OIRA 201805-0730-001
DOD/DFAS
Waiver/Remission of Indebtedness Application
Extension without change of a currently approved collection   No
Regular 07/20/2021
  Requested Previously Approved
36 Months From Approved 07/31/2021
4,500 4,500
6,000 6,000
43,500 43,500

Information is used to determine an individual's entitlement to relief from a claim owed the U.S. Government. Government claims examiners use information provided to determine whether there is indication of fraud, misrepresentation, and fault on the part of the individual, or whether it's in the best interest of the government to collect debt. The information collected on this form will be used by the DFAS to determine whether there is indication of fraud, misrepresentation, fault, or lack of good faith, and whether it is in the best interest of the United States to forgive the debt. It will also be used to determine if a debtor should have been reasonably aware of the overpayment when it occurred.

US Code: 10 USC 2774 Name of Law: Claims for overpayment of pay and allowances and of travel and transportation allowances
   US Code: 5 USC 5584 Name of Law: Claims for overpayment of pay and allowances, and of travel, transportation and relocation expense
   US Code: 10 USC 4837 Name of Law: Settlement of accounts, remission or cancellation of indebtedness of members
   US Code: 10 USC 6161 Name of Law: Settlement of accounts: remission or cancellation of indebtedness of members
   US Code: 10 USC 9837 Name of Law: Settlement of accounts: remission or cancellation of indebtedness of members
   US Code: 32 USC 716 Name of Law: Claims for overpayment of pay and allowances, and travel and transportation allowances
  
None

Not associated with rulemaking

  86 FR 26709 05/17/2021
86 FR 38319 07/20/2021
No

1
IC Title Form No. Form Name
Waiver/Remission of Indebtedness Application DD2789 WAIVER/REMISSION OF INDEBTEDNESS APPLICATION

  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 4,500 4,500 0 0 0 0
Annual Time Burden (Hours) 6,000 6,000 0 0 0 0
Annual Cost Burden (Dollars) 43,500 43,500 0 0 0 0
No
No

$148,185
No
    Yes
    Yes
No
No
No
No
Kellen Stout 317 645-3128 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
07/20/2021


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