Information Collection Request

Income Verification Express Service Application and Employee Delegation Form

ICR 200607-1545-044 · OMB 1545-2032 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 13803 Income Verification Express Service Application and Employee Delegation Form Form New Available
RevProc Draft 6-13-06[1].doc Supplementary Document Uploaded 2006-08-07 Available
SSNFORM051006.doc Supporting Statement A Uploaded 2006-07-26 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
44344 Income Verification Express Service Application and Employee Delegation Form Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2007 6 Months From Approved
200 0 0
100 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Income Verification Express Service Application and Employee Delegation Form 13803 Income Verification Express Service

table that charts list of burden
  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 200 0 0 200 0 0
Annual Time Burden (Hours) 100 0 0 100 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No