Information Collection

Treasury Direct Forms

IC 16570 under ICR 202401-1530-001 · OMB 1530-0042.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FS Form 5178 Treasury Direct Forms	Form and Instruction
Form FS Form 5178 Transaction Request Treasury Direct Forms	Form and Instruction
Form FS Form 5179 Security Transfer Request Treasury Direct Forms	Form and Instruction
Form FS Form 5188 Durable Power of Attorney for Securities and Savings Bonds Transactions Treasury Direct Forms	Form and Instruction
Form FS Form 5191 Application for Recognition as a Natural Guardian of a Minor Treasury Direct Forms	Form and Instruction
Form FS Form 5235 Report of Non-Receipt, Loss, Theft, or Destruction of a Fiscal Agency Check and Application for Replacement Treasury Direct Forms	Form and Instruction
Form FS Form 5236 Claim for Proceeds of a Check Treasury Direct Forms	Form and Instruction
FS Form 5178 Transaction Request sec5178.pdf www.treasurydirect.gov/forms/sec5178.pdf	Form and Instruction
FS Form 5178 Transaction Request sec5178.pdf www.treasurydirect.gov/forms/sec5178.pdf	Form and Instruction
FS Form 5179 Security Transfer Request sec5179.pdf www.treasurydirect.gov/forms/sec5179.pdf	Form and Instruction
FS Form 5179 Security Transfer Request sec5179.pdf www.treasurydirect.gov/forms/sec5179.pdf	Form and Instruction
FS Form 5188 Durable Power of Attorney for Securities and Savings Bon sav5188.pdf www.treasurydirect.gov/forms/sav5188.pdf	Form and Instruction
FS Form 5188 Durable Power of Attorney for Securities and Savings Bon sav5188.pdf www.treasurydirect.gov/forms/sav5188.pdf	Form and Instruction
FS Form 5191 Application for Recognition as a Natural Guardian of a M sec5191.pdf www.treasurydirect.gov/forms/sec5191.pdf	Form and Instruction
FS Form 5191 Application for Recognition as a Natural Guardian of a M sec5191.pdf www.treasurydirect.gov/forms/sec5191.pdf	Form and Instruction
FS Form 5235 Report of Non-Receipt, Loss, Theft, or Destruction of a sec5235.pdf www.treasurydirect.gov/forms/sec5235.pdf	Form and Instruction
FS Form 5235 Report of Non-Receipt, Loss, Theft, or Destruction of a sec5235.pdf www.treasurydirect.gov/forms/sec5235.pdf	Form and Instruction
FS Form 5236 Claim for Proceeds of a Check FSF5236.pdf	Form and Instruction
FS Form 5236 Claim for Proceeds of a Check FSF5236.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Treasury Direct Forms

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FS Form 5178	https://www.treasurydirect.gov/forms/sec5178.pdf	Yes	No	Fillable Printable
Form and Instruction	FS Form 5179	https://www.treasurydirect.gov/forms/sec5179.pdf	Yes	No	Fillable Printable
Form and Instruction	FS Form 5188	https://www.treasurydirect.gov/forms/sav5188.pdf	Yes	No	Fillable Printable
Form and Instruction	FS Form 5191	https://www.treasurydirect.gov/forms/sec5191.pdf	Yes	No	Fillable Printable
Form and Instruction	FS Form 5235	https://www.treasurydirect.gov/forms/sec5235.pdf	Yes	No	Fillable Printable
Form and Instruction	FS Form 5236		Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: Treasury/Fiscal Service.013 â United States Securities and Access

FR Citation: 85 FR 11776

Number of Respondents: 5,100

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	Previously Approved
Annual Number of Responses for this IC	5,100	5,100
Annual IC Time Burden (Hours)	1,105	1,105
Annual IC Cost Burden (Dollars)	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.

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