Information Collection Request

Credit Card Payment Form (1-786)

ICR 202304-1110-004 · OMB 1110-0070 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1-786 Credit Card Payment Form Form and Instruction Modified Available
Paperwork Certificate 0070 2023.docx Supplementary Document Uploaded 2023-07-18 Repair queued
28 CFR Part 16 Sub C.pdf Supplementary Document Uploaded 2023-07-18 Repair queued
0070 memorandum Scan.pdf Supplementary Document Uploaded 2023-07-18 Repair queued
0070 Privacy Assessment.pdf Supplementary Document Uploaded 2023-07-18 Repair queued
1110-0070 83-i_2023.pdf Supplementary Document Uploaded 2023-07-18 Repair queued
1110-0070 Supporting Statement A-1-786_2023.docx Supporting Statement A Uploaded 2023-07-18 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
222847 Credit Card Payment Form Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 07/31/2023
28,039 80,000
935 2,667
504,702 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Credit Card Payment Form 1-786 Credit Card Payment Form

table that charts list 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 28,039 80,000 0 -51,961 0 0
Annual Time Burden (Hours) 935 2,667 0 -1,732 0 0
Annual Cost Burden (Dollars) 504,702 0 0 504,702 0 0


Reginfo record details
  No