Information Collection

Statement Of Employment And Financial Interests (for Use By State Employees)

IC 118413 under ICR 198608-1029-001 · OMB 1029-0067.

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Information Collection (IC) Details

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IC Title:	STATEMENT OF EMPLOYMENT AND FINANCIAL INTERESTS (FOR USE BY STATE EMPLOYEES)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

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: 1,989	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,989	65	1,924
Annual IC Time Burden (Hours)	667	28	639
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.