REQUEST FOR WIN RELOCATION PAYMENT

ICR 198110-1205-007

OMB: 1205-0167

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
120942 Migrated
ICR Details
1205-0167 198110-1205-007
Historical Active
DOL/ETA
REQUEST FOR WIN RELOCATION PAYMENT
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/08/1981
Retrieve Notice of Action (NOA) 10/28/1981
  Inventory as of this Action Requested Previously Approved
10/31/1982 10/31/1982
160 0 0
16 0 0
0 0 0

THIS FORM PROVIDES A FORMAT FOR RECORDING TYPE AND AMOUNT OF RELOCATION EXPENSE AND CERTIFICATION. IT IS USED TO REQUEST AND APPROVE RELOCATION PAYMENTS, IT SERVES AS A BASIS IN THE PAYMENT UNIT FOR ESTABLISHING A PAYMENT ACCOUNT, FOR SETTING UP NECESSARY CONTROLS, AND FOR ISSUING PAYMENTS AUTHORIZED.

None
None


No

1
IC Title Form No. Form Name
REQUEST FOR WIN RELOCATION PAYMENT ETA 2228

  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 160 0 0 0 160 0
Annual Time Burden (Hours) 16 0 0 0 16 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.
10/28/1981


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