Information Collection Request

Repayment of Debt

ICR 202303-3220-005 · OMB 3220-0169 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 3220-0169 can be found here:

Forms and Documents

Forms and supporting documents for this ICR
Document	Type	Status	Availability
Form G-421F (04-20) Repayment by Credit Card	Form	Modified	Repair queued
Form G-421F (04-20) Repayment by Credit Card	Form	Modified	Repair queued
3220-0169 .docx	Supporting Statement A	Uploaded 2023-03-28	Repair queued
Form DRL-145 (12-17).pdf	Supplementary Document	Uploaded 2017-12-28	Missing upstream
Form DR-422B (02-18).pdf	Supplementary Document	Uploaded 2023-03-21	Repair queued
Form DR-422A (02-18).pdf	Supplementary Document	Uploaded 2023-03-21	Repair queued
Form DRL-145 (07-16).pdf	Supplementary Document	Uploaded 2016-08-04	Repair queued
Form SSA-714 (07-05).pdf	Supplementary Document	Uploaded 2016-06-08	Missing upstream
Form G-66BA (03-13).pdf	Supplementary Document	Uploaded 2016-06-08	Repair queued
DR-422C (09-19).pdf	Supplementary Document	Uploaded 2023-03-21	Repair queued
Form G-421 (02-18).pdf	Supplementary Document	Uploaded 2023-03-21	Missing upstream
G-66B (02-03).pdf	Supplementary Document	Uploaded 2006-09-29	Repair queued
G-66 (02-03).pdf	Supplementary Document	Uploaded 2006-09-29	Repair queued
Form G-66A (03-13).pdf	Supplementary Document	Uploaded 2016-06-08	Repair queued

Information collection document groups
IC ID	Collection	Type	Status	Form
45464	Repayment by Credit Card	Form	Modified
33968	Repayment by Credit Card	Form	Modified

Record metadata
Status	Received in OIRA
Agency/Subagency	RRB
OMB Control No	3220-0169
Type of Information Collection	Extension without change of a currently approved collection
Previous ICR Reference No	201912-3220-005
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31