Authorization Agreement for Preauthorized Payment

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Authorization Agreement for Preauthorized Payment	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:

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 .013—Collections 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 %

	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

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.