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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Assignment Form	Form
Assignment Form Assignment.pdf	Form

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.