SUPPLEMENTAL QUALIFICATIONS STATEMENTS

ICR 198101-3206-008

OMB: 3206-0038

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
176607 Migrated
ICR Details
3206-0038 198101-3206-008
Historical Active 198002-3206-004
OPM
SUPPLEMENTAL QUALIFICATIONS STATEMENTS
No material or nonsubstantive change to a currently approved collection   No
Emergency 01/30/1981
Approved with change 01/30/1981
Retrieve Notice of Action (NOA) 01/30/1981
  Inventory as of this Action Requested Previously Approved
08/31/1981 08/31/1981 08/31/1981
150,000 0 1,046,310
100,000 0 227,928
0 0 0

USED TO OBTAIN DETAILED INFORMATION FROM APPLICANTS FOR FEDERAL POSITIONS WHICH ENABLES DETERMINATIONS OF ELIGIBILITY. USUALLY SUPPLEMENTS INFORMATION OBTAINED ON SF 171 AND SF 171-A.

None
None


No

1
IC Title Form No. Form Name
SUPPLEMENTAL QUALIFICATIONS STATEMENTS CSC 1170, OPM 1170

  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 150,000 1,046,310 0 0 -896,310 0
Annual Time Burden (Hours) 100,000 227,928 0 0 -127,928 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.
01/30/1981


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