Information Collection

Statement and Acknowledgment (SF 1413); FAR sections affected; 22.406-5, 22.407(a), 52.222-11(b), 53.222(e), 53.301-SF 1413

IC 36405 under ICR 200103-9000-004 · OMB 9000-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 9000-0014 can be found here:

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Information Collection (IC) Details

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IC Title:	Statement and Acknowledgment (SF 1413); FAR sections affected; 22.406-5, 22.407(a), 52.222-11(b), 53.222(e), 53.301-SF 1413	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: 31,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	63,000	42,000	21,000
Annual IC Time Burden (Hours)	3,150	0	3,150
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.