Alternate Employment Information Request

ICR 200211-1215-001

OMB: 1215-0199

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
13936
Migrated
ICR Details
1215-0199 200211-1215-001
Historical Active
DOL/ESA
Alternate Employment Information Request
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 01/08/2003
Retrieve Notice of Action (NOA) 11/06/2002
Approved. This information collection does not use a standard form or format. To collect this information, OWCP will use various methods to contact designated employers and request that they submit employment data.
  Inventory as of this Action Requested Previously Approved
01/31/2006 01/31/2006
2,000 0 0
1,000 0 0
0 0 0

When the Department of Energy (DOE) is unable to verify an alleged employment history, OWCP will request factual data from current and former DOE contractors to confirm the alleged history.

None
None


No

1
IC Title Form No. Form Name
Alternate Employment Information Request

  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 2,000 0 0 2,000 0 0
Annual Time Burden (Hours) 1,000 0 0 1,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
11/06/2002


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