Notice of Reclamation

Forms and Documents

Document Name	Status
Form FMS-133 Notice of Reclamation Form	Modified
1510-0043_Supporting Statement_FMS133_REV-JUN2012.docx Supporting Statement A	2012-07-31

IC Document Collections

IC ID	Document Title	Status
15406	Notice of Reclamation Form	Modified

ICR Details

OMB Control No: 1530-0003	ICR Reference No: 201407-1530-003
Status: Historical Active	Previous ICR Reference No: 200904-1510-009
Agency/Subagency: TREAS/FISCAL	Agency Tracking No:
Title: Notice of Reclamation
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request:
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/11/2014
	Date Received in OIRA: 07/11/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2015	36 Months From Approved
Responses	223,128	0	396,674
Time Burden (Hours)	29,750	0	79,335
Cost Burden (Dollars)	0	0	0

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Abstract: A program agency authorizes Treasury to recover payments that have been issued after the death of the beneficiary. FMS Form 133 is used to notify the financial institution. If the financial institution does not respond to the FMS-133, a debit request (Form 135) is sent to the Federal Reserve Bank.

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Authorizing Statute(s): US Code: 31 USC 301 Name of Law: null
   US Code: 12 USC 391 Name of Law: null
  

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:
	77 FR 22066	04/12/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 44713	07/30/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Notice of Reclamation	FMS-133	Direct Deposit EFT Federal Recurring Payments-Notice of Reclamation

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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	223,128	396,674	0	0	-173,546	0
Annual Time Burden (Hours)	29,750	79,335	0	0	-49,585	0
Annual Cost Burden (Dollars)	0	0	0	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: No

Burden Reduction Due to:

Short Statement: FMS Form 135 is a request from the Department of the Treasury to the Federal Reserve Bank to debit an account from a financial institution for the amount issued after the date of non-entitlement due to the death or legal incapacity an individual. This activity is between two federal agencies and does not require PRA clearance and has been removed from this information collection request. The number of respondents is reduced from 55,000 to 27,500 due to the removal FMS-135, resulting in a reduction of 198,337 responses and a reduction of 39,667 hours in burden due to an adjustment. Current data provides a more accurate account of the number or respondents as well as the overall calculation of the burden. A burden reduction 49,585 hours is due to an adjustment in agency estimates. Total burden request this submission is 29,750 hours.

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Annual Cost to Federal Government: $1,236,250

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: 07/31/2012

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