OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Claim Against the United States for the Proceeds of a Government Check

ICR 201407-1530-010 · OMB 1530-0010 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form FMS 1133 FMS-1133, Claim Against the United States for the Proceeds of a Government Check Form and Instruction Modified Repair queued
1510-0019_SS_FMS 1133_REV-SEP2013.doc Supporting Statement A Uploaded 2013-09-09 Available
IC Document Collections
IC IDCollectionTypeStatusForm
15380 FMS-1133, Claim Against the United States for the Proceeds of a Government Check Form and Instruction Modified
ICR Details
1530-0010 201407-1530-010
Historical Active 201003-1510-005
TREAS/FISCAL
Claim Against the United States for the Proceeds of a Government Check
Revision of a currently approved collection   No
Approved without change 07/11/2014
Retrieve Notice of Action (NOA) 07/11/2014
  Inventory as of this Action Requested Previously Approved
11/30/2016 36 Months From Approved
27,640 0 67,649
4,608 0 11,278
0 0 0
This form is used to collect information needed to process an individual's claim for non-receipt of proceeds from a U.S. Treasury check. Once the information is analyzed, a determination is made and a recommendation is submitted to the program agency to either settle or deny the claim.
US Code: 31 USC Sec. 321, 3331-3343 Name of Law: Money and Finance; General authority of the Secretary
  
None
Not associated with rulemaking
  78 FR 33774 06/05/2013
78 FR 53503 08/29/2013
No
  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 27,640 67,649 0 0 -40,009 0
Annual Time Burden (Hours) 4,608 11,278 0 0 -6,670 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The decrease in burden hours is an adjustment based on actual data gathered on the number of respondents.
$377,500
No
Yes
No
No
No
Uncollected
Ella White 202 874-8445 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/29/2013