Applicant Background Questionnaire

ICR 200607-2105-001

OMB: 2105-0557

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
44071 Migrated
ICR Details
2105-0557 200607-2105-001
Historical Active
DOT/OST
Applicant Background Questionnaire
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 08/11/2006
Retrieve Notice of Action (NOA) 07/12/2006
Information collection instrument was revised consistently with statistical standards for data on ethnicity and race.
  Inventory as of this Action Requested Previously Approved
08/31/2009 36 Months From Approved
120,000 0 0
6,000 0 0
0 0 0

This information will be gathered from applicants and internal DOT employees. It is used to respond to EEOC, MSPB, OSC, DOJ etc. requests for information, mandated statistical reports, and evaluate hiring/outreach efforts.

None
None


No

1
IC Title Form No. Form Name
Applicant Background Questionnaire none Applicant Background Questionnaire

  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 120,000 0 0 120,000 0 0
Annual Time Burden (Hours) 6,000 0 0 6,000 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.
07/12/2006


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