Information Collection

Annual Disclosure Report

IC 152428 under ICR 198108-3068-006 · OMB 3068-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3068-0014 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	ANNUAL DISCLOSURE REPORT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 375	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	375	25	350
Annual IC Time Burden (Hours)	15,000	11,500	3,500
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.