Information Collection

Worksheets For Determination Of Qualification

IC 130197 under ICR 198110-1545-045 · OMB 1545-0605.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

WORKSHEETS FOR DETERMINATION OF QUALIFICATION

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	5622, 5623,	No	No
Form	5626, 5627	No	No
Form	5624, 5625,	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 22,400

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	134,400	134,400
Annual IC Time Burden (Hours)	134,400	134,400
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.

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