Information Collection

Authorization to Disclose Information Related To Stored Value Account

IC 223474 under ICR 202603-1530-001 · OMB 1530-0013.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FS Form 5752 Authorization to Disclose Information Related to Stored Value Account Authorization to Disclose Information Related To Stored Value Account	Form and Instruction
FS Form 5752 Authorization to Disclose Information Related to Stored FS Form 5752.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

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 and Instruction	FS Form 5752				Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: Collections Records-Treasury/FMS.017

FR Citation: 77 FR 62602

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	1	1
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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