Employment - Reference Inquiry

ICR 200307-1545-002

OMB: 1545-0274

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
17209 Migrated
ICR Details
1545-0274 200307-1545-002
Historical Active 200004-1545-024
TREAS/IRS
Employment - Reference Inquiry
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 07/03/2003
Retrieve Notice of Action (NOA) 07/03/2003
  Inventory as of this Action Requested Previously Approved
07/31/2006 07/31/2006
20,000 0 0
4,000 0 0
0 0 0

Form 2163(c) is used by IRS to verify past employment and to question listed and developed references as to the character and integrity of current and potential IRS employees. The information received is incorporated into a report on which a security determination is based.

None
None


No

1
IC Title Form No. Form Name
Employment - Reference Inquiry 2163(C)

  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 20,000 0 0 20,000 0 0
Annual Time Burden (Hours) 4,000 0 0 4,000 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.
07/03/2003


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