SUPPLEMENTARY INFORMATION:
Fiscal Service (FS)
1.
Title:
Claim Against the United States for the Proceeds of a Government Check.
OMB Control Number:
1530-0010.
Type of Review:
Extension without change of a currently approved collection.
Description:
The forms are 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.
Form:
FS Form 1133 and FS Form 1133-A.
Affected Public:
Individuals or households.
Estimated Number of Respondents:
51,640.
Frequency of Response:
On Occasion.
Estimated Total Number of Annual Responses:
51,640.
Estimated Time per Response:
10 minutes.
Estimated Total Annual Burden Hours:
8,609 hours.
2.
Title:
Special Form of Assignment for U.S. Registered Securities.
OMB Control Number:
1530-0058.
Type of Review:
Extension without change of a currently approved collection.
Description:
FS Form 1832 is used by owners, or authorized representatives, to complete transactions involving the assignment of U.S. Registered and Bearer Securities.
Form:
FS Form 1832.
Affected Public:
Individuals or households.
Estimated Number of Respondents:
10.
Frequency of Response:
On Occasion.
Estimated Total Number of Annual Responses:
10.
Estimated Time per Response:
15 minutes.
Estimated Total Annual Burden Hours:
2.5 hours.
3.
Title:
Disclaimer and Consent With Respect To United States Savings Bonds/Notes.
OMB Control Number:
1530-0059.
Type of Review:
Extension without change of a currently approved collection.
Description:
A disclaimer and consent may be necessary when, as the result of an error in registration or otherwise, the payment, refund of purchase price, or reissue of savings bonds/notes as requested by one person would appear to affect the right, title or interest of some other person.
Form:
FS Form 1849.
Affected Public:
Individuals or households.
Estimated Number of Respondents:
450.
Frequency of Response:
On Occasion.
Estimated Total Number of Annual Responses:
450.
Estimated Time per Response:
6 minutes.
Estimated Total Annual Burden Hours:
45 hours.
4.
Title:
Checklists of Filings for Certified Surety and/or Certified Reinsuring Companies and for Admitted Reinsurer Companies.
OMB Control Number:
1530-0061.
Type of Review:
Extension without change of a currently approved collection.
Description:
This information is collected from insurance companies to assist the Treasury Department in determining acceptability of the companies applying for a Certificate of Authority to write or reinsure Federal surety bonds and/or gain recognition as an Admitted Reinsurer.
Form:
Annual Filing Checklist Certified Companies; Annual Filing Checklist Admitted Reinsurers.
Affected Public:
Businesses or other for-profit.
Estimated Number of Respondents:
30.
Frequency of Response:
On Occasion.
Estimated Total Number of Annual Responses:
30.
Estimated Time per Response:
5 hours.
Estimated Total Annual Burden Hours:
150 hours.
5.
Title:
Subscription for Purchase and Issue of U.S. Treasury Securities—State and Local Government Series.
OMB Control Number:
1530-0065.
Type of Review:
Extension without change of a currently approved collection.
Description:
The information is requested to establish and maintain accounts for the owners of securities of the State and Local Government Series.
Form:
FS Form 4144; FS Form 4144-1; FS Form 4144-2; FS Form 4144-5; FS Form 4144-6; FS Form 4144-7; FS Form 5377; FS Form 5237; and FS Form 5238.
Affected Public:
State and Local Governments.
Estimated Number of Respondents:
6,437.
Frequency of Response:
On Occasion.
Estimated Total Number of Annual Responses:
6,437.
Estimated Time per Response:
24 minutes.
Estimated Total Annual Burden Hours:
2,578 hours.
Authority:44 U.S.C. 3501
et seq.
Dated: October 19, 2021.
Molly Stasko,
Treasury PRA Clearance Officer.