Information Collection

Prisoner Matching Agreements

IC 46562 under ICR 200612-0960-019 · OMB 0960-0749.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
eData Prisoner Reporting Screens 05-11-07.pdf	Other-Application Screens
PRA Language Prisoner Reporting 04-30-07.doc PRA Language Insert	IC Document

IC Title:

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Application Screens			eData Prisoner Reporting Screens 05-11-07.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	36,000	36,000
Annual IC Time Burden (Hours)	36,000	36,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PRA Language Insert	PRA Language Prisoner Reporting 04-30-07.doc	04/30/2007

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