REFERRAL CARD - REPORT ON PLACEMENT OR REFUSAL OF REFERRAL OR JOB OFFER TO RRB

ICR 197502-3220-012

OMB: 3220-0027

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
3220-0027 197502-3220-012
Historical Active 197502-3220-011
RRB
REFERRAL CARD - REPORT ON PLACEMENT OR REFUSAL OF REFERRAL OR JOB OFFER TO RRB
No material or nonsubstantive change to a currently approved collection   No
Emergency 02/21/1975
Approved with change 02/21/1975
Retrieve Notice of Action (NOA) 02/21/1975
  Inventory as of this Action Requested Previously Approved
04/30/1980 04/30/1980 03/31/1980
10,500 0 10,500
883 0 883
0 0 0



None
None


No

1
IC Title Form No. Form Name
REFERRAL CARD - REPORT ON PLACEMENT OR REFUSAL OF REFERRAL OR JOB OFFER TO RRB ES-21, ES-21C

  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 10,500 10,500 0 0 0 0
Annual Time Burden (Hours) 883 883 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
02/21/1975


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