Request For Information Regarding Deceased Debtor

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD Form 2840 Request for Information Regarding Deceased Debtor	Form	Modified	Available
Form DD Form 2840 Request For Information Regarding Deceased Debtor (Family member)	Form	Modified	Repair queued
Form DD Form 2840 Request for Information Regarding Deceased Debtor	Form	Modified	Available
Form DD Form 2840 Request For Information Regarding Deceased Debtor (Probate Clerk)	Form	Modified	Repair queued
0730-0015_SSA_6.26.2024.docx	Supporting Statement A	Uploaded 2024-06-27	Repair queued
Estate Claim ltr.doc	Supplementary Document	Uploaded 2018-02-02	Repair queued
Estate Claim.doc	Supplementary Document	Uploaded 2018-02-02	Repair queued
0730-0015_SSN Memo_8.31.2017.pdf	Supplementary Document	Uploaded 2024-06-27	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5651	Request For Information Regarding Deceased Debtor (Family member)	Form	Modified	Request for Information Regarding Deceased Debtor
5651	Request For Information Regarding Deceased Debtor (Family member)	Form	Modified
246748	Request For Information Regarding Deceased Debtor (Probate Clerk)	Form	Modified	Request for Information Regarding Deceased Debtor
246748	Request For Information Regarding Deceased Debtor (Probate Clerk)	Form	Modified

ICR Details

OMB Control No: 0730-0015	ICR Reference No: 202406-0730-002
Status: Active	Previous ICR Reference No: 202104-0730-001
Agency/Subagency: DOW/DFAS	Agency Tracking No: 0730-0015
Title: Request For Information Regarding Deceased Debtor
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/06/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/27/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2027	36 Months From Approved	08/31/2024
Responses	300	0	300
Time Burden (Hours)	51	0	51
Cost Burden (Dollars)	565	0	533

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Abstract: The information collection requirement is necessary to obtain information on deceased debtors from probate courts. Probate courts review their records to see if an estate was established. They provide the name and address of the executor or lawyer handling the estate. From the information obtained, DFAS submits a claim against the estate for the amount due the United States.

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Authorizing Statute(s): PL: Pub.L. 102 - 484 614 Name of Law: National Defense Authorization Act for Fiscal Year 1993
   US Code: 31 USC 3111 Name of Law: New Issue Used to Buy, Redeem, or Refund Outstanding Obligations
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 29314	04/22/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 53401	06/26/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Request For Information Regarding Deceased Debtor (Family member)	DD Form 2840	Request for Information Regarding Deceased Debtor
Request For Information Regarding Deceased Debtor (Probate Clerk)	DD Form 2840	Request for Information Regarding Deceased Debtor

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	300	300	0	0	0	0
Annual Time Burden (Hours)	51	51	0	0	0	0
Annual Cost Burden (Dollars)	565	533	0	32	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $345

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/27/2024

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