Request for Payment of Reissue of U.S. Savings Bonds Deposited in Safekeeping

Forms and Documents

Document Name	Status
Form FS Form 4239 Request for payment or reissue of U.S. Savings Bonds deposited in Safekeeping Form and Instruction	Modified
Supporting Statement_1530-0024_2025.docx Supporting Statement A	2025-09-25

IC Document Collections

IC ID	Document Title	Status
16558	Request for payment or reissue of U.S. Savings Bonds deposited in Safekeeping Form and Instruction	Modified

ICR Details

OMB Control No: 1530-0024	ICR Reference No: 202509-1530-003
Status: Received in OIRA	Previous ICR Reference No: 202207-1530-001
Agency/Subagency: TREAS/FISCAL	Agency Tracking No:
Title: Request for Payment of Reissue of U.S. Savings Bonds Deposited in Safekeeping
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/31/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2025
Responses	1,260	1,400
Time Burden (Hours)	210	233
Cost Burden (Dollars)	0	0

---

Abstract: The information is necessary to request payment or reissue of Savings Bonds/Notes held in safekeeping when original safekeeping custody receipts are not available. The information on the form is used by the Department of the Treasury, Bureau of the Fiscal Service, to identify the securities involved, establish entitlement, and to obtain a certified request for payment or reissue. Without the information, the transaction cannot be completed.

---

Authorizing Statute(s): US Code: 31 USC Part 353
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 29103	07/02/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 48959	10/31/2025
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Request for payment or reissue of U.S. Savings Bonds deposited in Safekeeping	FS Form 4239	REQUEST BY OWNER OR PERSON ENTITLED TO PAYMENT OR REISSUE OF UNITED STATES SAVINGS BONDS/NOTES DEPOSITED IN SAFEKEEPING WHEN ORIGINAL CUSTODY RECEIPTS ARE NOT AVAILABLE

---

ICR Summary of Burden

	Total Request	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	1,260	1,400	0	-140	0	0
Annual Time Burden (Hours)	210	233	0	-23	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The form in this collection is used in processes related to securities that are no longer issued in paper form. The reduction of 23 burden hours is a program change due to agency discretion for a total of 210 hours requested.

---

Annual Cost to Federal Government: $48,094

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

---

Common Form ICR:  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:

(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: 10/31/2025

---