Prior Government Service Information

ICR 200412-1545-013

OMB: 1545-1919

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
19618 Migrated
ICR Details
1545-1919 200412-1545-013
Historical Active
TREAS/IRS
Prior Government Service Information
New collection (Request for a new OMB Control Number)   No
Emergency 12/27/2004
Approved without change 12/21/2004
Retrieve Notice of Action (NOA) 12/20/2004
  Inventory as of this Action Requested Previously Approved
06/30/2005 06/30/2005
24,813 0 0
6,203 0 0
0 0 0

Form 12854 is used to record prior government service, annuitant information and to advice on probationary periods.

None
None


No

1
IC Title Form No. Form Name
Prior Government Service Information 12854

  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 24,813 0 0 24,813 0 0
Annual Time Burden (Hours) 6,203 0 0 6,203 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.
12/20/2004


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