Information Collection

Privacy Act - Form Of Request For Notification Of Whether A Record Exists, Form Of Request To Amend Records, Form Of Request For Appeal Of Refusal To Amend Records

IC 124490 under ICR 198910-1505-001 · OMB 1505-0065.

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Information Collection (IC) Details

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IC Title:	PRIVACY ACT - FORM OF REQUEST FOR NOTIFICATION OF WHETHER A RECORD EXISTS, FORM OF REQUEST TO AMEND RECORDS, FORM OF REQUEST FOR APPEAL OF REFUSAL TO AMEND RECORDS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

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: 2,966	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,966	1,966	1,000
Annual IC Time Burden (Hours)	2,966	1,966	1,000
Annual IC Cost Burden (Dollars)	0	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.