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Investigation Of Claim For Possible Days Of Employment Or State Benefits Received
INVESTIGATION OF CLAIM FOR POSSIBLE DAYS OF EMPLOYMENT OR STATE BENEFITS RECEIVED
OMB: 3220-0049
IC ID: 177011
OMB.report
RRB
OMB 3220-0049
ICR 199405-3220-003
IC 177011
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0049 can be found here:
1997-06-26 - Revision of a currently approved collection
1994-05-05 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
INVESTIGATION OF CLAIM FOR POSSIBLE DAYS OF EMPLOYMENT OR STATE BENEFITS RECEIVED
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
Form
ID-51
No
No
Form
ID-5R(SUP)
No
No
Form
ID-49R
No
No
Form
ID-49S
No
No
Form
UI-48
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
11,250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
11,300
0
0
0
0
11,300
Annual IC Time Burden (Hours)
2,047
0
0
0
0
2,047
Annual IC Cost Burden (Dollars)
0
0
0
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.