Information Collection

Investigation of Claim for Possible Days of Employment or State Benefits Received

IC 33862 under ICR 199706-3220-004 · OMB 3220-0049.

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Information Collection (IC) Details

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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.	Available Electronically?	Can Be Submitted Electronically?
Form	ID-5I	No	No
Form	UI-48	No	No
Form	ID-5R(SUP)	No	No
Form	ID-49R	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,900	94,553	-99,253	10,600
Annual IC Time Burden (Hours)	1,388	342	-359	1,405
Annual IC Cost Burden (Dollars)	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.