Information Collection

Sample Agreement--Prison Matching

IC 181825 under ICR 200612-0960-019 · OMB 0960-0749.

Documents and Forms

Document Name Document Type
Sample Agreement -- Prison Matching F.pdf Instruction
PRA Language Prisoner Reporting 04-30-07.doc Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Sample Agreement--Prison Matching	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 416.211 20 CFR 404.468

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			PRA Language Prisoner Reporting 04-30-07.doc		Yes	Yes	Fillable Fileable Signable
Instruction			Sample Agreement -- Prison Matching F.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.