Information Collection

Annual Policing Questionnaire Of Events Which May Affect Annuitant's Benefits

IC 177046 under ICR 197605-3220-004 · OMB 3220-0073.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	ANNUAL POLICING QUESTIONNAIRE OF EVENTS WHICH MAY AFFECT ANNUITANT'S BENEFITS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	G-19A	No	No
Form	19B	No	No
Form	19D	No	No
Form	19R	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	25,000	-9,000	34,000
Annual IC Time Burden (Hours)	4,590	-795	5,385
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.