Information Collection

Individuals or Households

IC 242049 under ICR 202604-3060-026 · OMB 3060-0589.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 159 Remittance Advice Individuals or Households	Form and Instruction
Form Form 159 Remittance Advice Individuals or Households	Form and Instruction
159-B_final version with OMB approval 2023.pdf	Other-Screen Shots
159-B_final version with OMB approval 2023.pdf	Other-Screen Shots
Form 159 Remittance Advice 159Form Original_final version with OMB approval 2023.pdf	Form and Instruction
Form 159 Remittance Advice 159Form Original_final version with OMB approval 2023.pdf	Form and Instruction

IC Title:

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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 159				Yes	Yes	Fillable Fileable Signable
Other-Screen Shots					Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: FCC/OMD-25 Financial Operation Information System (FOIS)

FR Citation: 81 FR 69522

Number of Respondents: 79,348

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	79,348	19,348	60,000
Annual IC Time Burden (Hours)	19,837	4,837	15,000
Annual IC Cost Burden (Dollars)	0	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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