Information Collection

Protected Employee Inventory Record And Claims For Reimbursement Allowances

IC 177141 under ICR 197703-3220-001 · OMB 3220-0111.

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: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

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

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,500

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11,500	500	11,000
Annual IC Time Burden (Hours)	933	0	933
Annual IC Cost Burden (Dollars)	0	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.