Financial Institution Data Match / Federally Assisted State Transmitted Levy

Forms and Documents

Document Name	Status
Form 1 FAST Levy Response Withhold Record Specifications: Multistate Financial Institutions Form	New
Form 1 FAST Levy Response Withhold Record Specifications: State CSE Form and Instruction	New
Form 1 Electronic Transmission Financial Data Match Result File Form and Instruction	Modified
Form 1 Financial Data Match Result File Form and Instruction	Modified
Form 1 Election Form Form and Instruction	Modified
2014_04_22_FIDM_FAST_Levy_Supporting_Statement_Final_REVISED_per OPRE_052314.doc Supporting Statement A	2014-05-23

IC Document Collections

IC ID	Document Title	Status
211685	FAST Levy Response Withhold Record Specifications: Multistate Financial Institutions Form	New
211684	FAST Levy Response Withhold Record Specifications: State CSE Form and Instruction	New
197583	Electronic Transmission Financial Data Match Result File Form and Instruction	Modified
182145	Financial Data Match Result File Form and Instruction	Modified
10015	Election Form Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0196	ICR Reference No: 201405-0970-002
Status: Historical Active	Previous ICR Reference No: 201108-0970-005
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Financial Institution Data Match / Federally Assisted State Transmitted Levy
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/16/2014
	Date Received in OIRA: 05/28/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved	09/30/2014
Responses	673	0	1,362
Time Burden (Hours)	3,974	0	403
Cost Burden (Dollars)	482,799	0	424,519

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Abstract: Section 466(a)(17) of the Social Security Act (the Act), requires states to establish procedures under which the state child support enforcement (IV-D) agency shall enter into agreements with financial institutions doing business in the state for the purpose of securing information leading to the enforcement of child support orders. Under 452(1) of the Act, financial institutions doing business in multiple states may comply by centrally matching through the Federal Parent Locator Service rather than matching in each state in which the financial institution conducts business.

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Authorizing Statute(s): US Code: 42 USC 666(a)(17) Name of Law: Financial Institution Data Match
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 6906	02/05/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 26871	05/12/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Financial Data Match Result File	1	Data Match Results Specification
FAST Levy Response Withhold Record Specifications: State CSE	1	FAST Levy Record Specs
FAST Levy Response Withhold Record Specifications: Multistate Financial Institutions	1	FAST Levy Record Specs
Election Form	1	Election Form
Electronic Transmission Financial Data Match Result File	1	MSFIDM Record Specs.

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ICR Summary of Burden

	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	673	1,362	0	-689	0	0
Annual Time Burden (Hours)	3,974	403	0	3,571	0	0
Annual Cost Burden (Dollars)	482,799	424,519	0	58,280	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The FIDM Specifications Handbook and Election Form include minor program changes which clarify verbiage and bring it up to date. An addtional program change was also made to the Election Form to exclude the CD-ROM file exchange option. It will no longer be an option for new participants to the program. These changes do not impact the response burden.

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Annual Cost to Federal Government: $972,581

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/28/2014

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