Applicant Background Survey

ICR 200603-1091-001

OMB: 1091-0001

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
11577 Migrated
ICR Details
1091-0001 200603-1091-001
Historical Active 200301-1091-001
DOI/OEO
Applicant Background Survey
Extension without change of a currently approved collection   No
Regular
Approved without change 04/21/2006
Retrieve Notice of Action (NOA) 03/17/2006
  Inventory as of this Action Requested Previously Approved
04/30/2009 04/30/2009 04/30/2006
535,160 0 560,000
26,758 0 46,480
0 0 0

The collection of personal background data onjob applicants for purposes of planning and assessing affirmative employment program initiatives. Under these procedures, applicants and selectees are requested to provide, or a purely voluntary basis, information on their race, ethin origin, gender, and disability to help ensure Department personnel practices meet the require- ments of Federal law.

None
None


No

1
IC Title Form No. Form Name
Applicant Background Survey 1935

  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 535,160 560,000 0 0 -24,840 0
Annual Time Burden (Hours) 26,758 46,480 0 0 -19,722 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
Yes Part B of Supporting Statement
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.
03/17/2006


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