ACH Vendor Payment Enrollment Form

ACH Vendor Payment Enrollment

Documents and Forms

Document Name Document Type
Form OWCP-3881 ACH Vendor Payment Enrollment Form Form and Instruction
OWCP-3881 ACH Vendor Payment Enrollment Form ACH Vendor Payment Enrollment Form (OWCP-3881) Proposed New Form_20250625.docx owcpmed.dol.gov/ Form and Instruction

Information Collection (IC) Details

IC Title:	ACH Vendor Payment Enrollment Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 10.801 20 CFR 30.701 20 CFR 725.705 20 CFR 725.714 20 CFR 725.704

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OWCP-3881	ACH Vendor Payment Enrollment Form	ACH Vendor Payment Enrollment Form (OWCP-3881) Proposed New Form_20250625.docx	https://owcpmed.dol.gov/	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/GOVT-1	FR Citation: 81 FR 47418

Number of Respondents: 35,424	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35,424	35,424
Annual IC Time Burden (Hours)	1,771	1,771
Annual IC Cost Burden (Dollars)	280	280

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.