Information Collection

Assignment Form

IC 15394 under ICR 200612-1510-001 · OMB 1510-0035.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1510-0035 can be found here:

Documents and Forms

Document Name Document Type
Assignment Form Form
Assignment Form Assignment.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Assignment Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NA	Assignment Form	Assignment.pdf		Yes	No	Printable Only

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	75	75
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.