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Certification By School Official
Certification By School Official
OMB: 1215-0061
IC ID: 13706
OMB.report
DOL/ESA
OMB 1215-0061
ICR 200702-1215-005
IC 13706
( )
Documents and Forms
Document Name
Document Type
Form CM-981
Certification By School Official
Form
CM-981 Certification By School Official
cm-981.pdf
www.dol.gov/esa/regs/compliance/owcp/cm-981.pdf
Form
DOL-ESA 6.doc
DOL-ESA 6
IC Document
30 USC 901-902.pdf
30USC901 - 902
IC Document
725.208 - .209.pdf
20CFR725.208 - 209
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Certification By School Official
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 725.208
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
CM-981
Certification By School Official
cm-981.pdf
http://www.dol.gov/esa/regs/compliance/owcp/cm-981.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
DOL/ESA-6
FR Citation:
67 FR 16869
Number of Respondents:
400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
400
0
0
-100
0
500
Annual IC Time Burden (Hours)
67
0
0
-17
0
84
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
DOL-ESA 6
DOL-ESA 6.doc
02/07/2007
30USC901 - 902
30 USC 901-902.pdf
02/07/2007
20CFR725.208 - 209
725.208 - .209.pdf
02/07/2007
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.