Applicant Background Survey

ICR 199806-0990-001

OMB: 0990-0208

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
10321
Migrated
ICR Details
0990-0208 199806-0990-001
Historical Active 199501-0990-001
HHS/HHSDM
Applicant Background Survey
Revision of a currently approved collection   No
Regular
Approved without change 08/07/1998
Retrieve Notice of Action (NOA) 06/10/1998
  Inventory as of this Action Requested Previously Approved
08/31/2001 08/31/2001 09/30/1998
310,000 0 310,000
10,333 0 10,333
0 0 0

To collect information on applicants for employment. Required by EEOC Management Directive 714. Purpose: To ensure recruitment sources yield qualified minority, female, and disabled applicants. Applicants for employment will provide data on how they learned of the vacancy. Sex, race, and national origin and disability status are also requested.

None
None


No

1
IC Title Form No. Form Name
Applicant Background Survey

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 310,000 310,000 0 0 0 0
Annual Time Burden (Hours) 10,333 10,333 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/10/1998


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