Information Collection

Protected Employee Inventory Record And Claims For Reimbursement Allowances

IC 157668 under ICR 197610-3220-001 · OMB 3220-0111.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

PROTECTED EMPLOYEE INVENTORY RECORD AND CLAIMS FOR REIMBURSEMENT ALLOWANCES

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	UI-91, UI-92	No	No
Form	UL-93	No	No
Form	UL-94	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	11,000	11,000
Annual IC Time Burden (Hours)	933	933
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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