View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1530-0040	ICR Reference No: 201904-1530-007
Status: Historical Active	Previous ICR Reference No: 201511-1530-008
Agency/Subagency: TREAS/FISCAL	Agency Tracking No:
Title: Affidavit of Forgery for United States Savings Bonds
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/10/2020
	Date Received in OIRA: 12/03/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2023	36 Months From Approved
Responses	10	0	0
Time Burden (Hours)	3	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	10	-990	1,000
Annual Time Burden (Hours)	3	-247	250
Annual Cost Burden (Dollars)	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The form is used in processes related to securities that are no longer issued in paper form. The reduction of 247 burden hours is a program change due to agency discretion for a total of 3 hours requested.

Annual Cost to Federal Government: $515

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

Agency Contact: Bruce Sharp 304 480-8112 Bruce.Sharp@bpd.treas.gov

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