Information Collection

Authorization Agreement for Preauthorized Payment

IC 15430 under ICR 202309-1530-002 · OMB 1530-0015.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF-5510 Authorization Agreement for Preauthorized Payment	Form
SF-5510 Authorization Agreement for Preauthorized Payment SF_5510_DraftSep2023.pdf	Form
SF-5510 Authorization Agreement for Preauthorized Payment SF_5510_DraftSep2023.pdf	Form
SF-5510sp ACUERDO PARA AUTORIZAR PAGOS PREAUTORIZADOS SF5510(spanish)Draft2023.pdf	Form
SF-5510sp ACUERDO PARA AUTORIZAR PAGOS PREAUTORIZADOS SF5510(spanish)Draft2023.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 31 CFR 202, 205, 206 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SF-5510	Authorization Agreement for Preauthorized Payment	SF_5510_DraftSep2023.pdf		Yes	No	Fillable Printable
Form	SF-5510sp	ACUERDO PARA AUTORIZAR PAGOS PREAUTORIZADOS	SF5510(spanish)Draft2023.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: Treasury/Fiscal Service .013âCollections Records

FR Citation: 85 FR 11776

Number of Respondents: 100,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	100,000	0	100,000
Annual IC Time Burden (Hours)	16,667	-8,333	25,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.