# Submission for OMB Review; Comment Request
The Department of the Treasury will submit the following information collection request to the Office of Management and Budget (OMB) for review and clearance in accordance with the Paperwork Reduction Act of 1995, Public Law 104-13, on or after the date of publication of this notice.
**DATES:**
Comments should be received on or before April 30, 2012 to be assured of consideration.
**ADDRESSES:**
Send comments regarding the burden estimate, or any other aspect of the information collection, including suggestion for reducing the burden, to (1) Office of Information and Regulatory Affairs, Office of Management and Budget, Attention: Desk Officer for Treasury, New Executive Office Building, Room 10235, Washington, DC 20503, or email at *[email protected]* and (2) Treasury PRA Clearance Officer, 1750 Pennsylvania Ave. NW., Suite 11020, Washington, DC 20220, or on-line at *www.PRAComment.gov.*
**FOR FURTHER INFORMATION CONTACT:**
Copies of the submission(s) may be obtained by calling (202) 927-5331, email at *[email protected],* or the entire information collection request maybe found at *www.reginfo.gov.*
**Bureau of Engraving and Printing (BEP)**
*OMB Number:* 1520-0001.
*Type of Review:* Extension without change of currently approved collection.
*Title:* Owner's Affidavit of Partial Destruction of Mutilated Currency.
*Form:* BEP 5283.
*Abstract:* The Office of Currency Standards, Bureau of Engraving & Printing, requests owners of partially destroyed U.S. currency to complete a notarized affidavit (BEP 5283) for each claim submitted when substantial portions of notes are missing.
*Affected Public:* Individuals or Households.
*Estimated Total Burden Hours:* 90.
Dawn D. Wolfgang,
Treasury PRA Clearance Officer.