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Financial Status Report (Short Form)
Financial Status Report (Short Form)
OMB: 1121-0264
IC ID: 12585
OMB.report
DOJ/OJP
OMB 1121-0264
ICR 200210-1121-003
IC 12585
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0264 can be found here:
2007-05-31 - No material or nonsubstantive change to a currently approved collection
2006-01-12 - 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:
Financial Status Report (Short Form)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
11,292
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
81,284
0
0
0
0
81,284
Annual IC Time Burden (Hours)
67,752
0
0
0
0
67,752
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.