Information Collection

FSR 219 GSA FCIC Consumidor, FSR 220 GSA Forms.gov, FSR 221 PBGC MyPBA, FSR 222 DOL DisabilityInfo

IC 182821 under ICR 200707-1505-002 · OMB 1505-0186.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0186 can be found here:

Documents and Forms

Document Name Document Type
Form FSR 219 FSR 219 GSA FCIC Consumidor, FSR 220 GSA Forms.gov, FSR 221 PBGC MyPBA, FSR 222 DOL DisabilityInfo Form
FSR 219 GSA FCIC Consumidor FSR 219 GSA FCIC Consumidor.xls Form
FSR 220 GSA Forms.gov FSR 220 GSA Forms.gov.xls Form
FSR 221 PBGC MyPBA FSR 221 PBGC MyPBA.xls Form
FSR 222 DOL DisabilityInfo FSR 222 DOL DisabilityInfo.xls Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FSR 219 GSA FCIC Consumidor, FSR 220 GSA Forms.gov, FSR 221 PBGC MyPBA, FSR 222 DOL DisabilityInfo	Agency IC Tracking Number:	FSR 219, FSR 220, FSR 221, FSR 222,

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FSR 219	GSA FCIC Consumidor	FSR 219 GSA FCIC Consumidor.xls	Yes	Yes	Fillable Fileable
Form	FSR 220	GSA Forms.gov	FSR 220 GSA Forms.gov.xls	Yes	Yes	Fillable Fileable
Form	FSR 221	PBGC MyPBA	FSR 221 PBGC MyPBA.xls	Yes	Yes	Fillable Fileable
Form	FSR 222	DOL DisabilityInfo	FSR 222 DOL DisabilityInfo.xls	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	20,000	0	0	0	0	0
Annual IC Time Burden (Hours)	833	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	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.