Information Collection

EVS One-Time Registration

IC 184379 under ICR 200803-0960-013 · OMB 0960-0660.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0660 can be found here:

Documents and Forms

Document Name Document Type
EVS One-Time Registration Form
EVS Individual Privacy Attestation.pdf Other-Privacy Attestation
EVS Third Party Privacy Attestation.pdf Other-Privacy Attestation
EVS Registration Form EVS Registration Form.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	EVS One-Time Registration	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 401.45

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	EVS Registration Form	EVS Registration Form.pdf	Yes	No	Printable Only
Other-Privacy Attestation			EVS Individual Privacy Attestation.pdf	Yes	No	Printable Only
Other-Privacy Attestation			EVS Third Party Privacy Attestation.pdf	Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	2	2
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.