Information Collection

Alternative Service Program Forms

IC 186206 under ICR 200808-3240-002 · OMB 3240-0038.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSS Form 152 Alternative Service Program Forms	Form and Instruction
SSS Form 152 Alternative Service Employment Agreement SSS FORM 152.pdf	Form and Instruction
SSS Form 153 Employer Data Sheet SSS FORM 153.pdf	Form and Instruction
SSS Form 156 Skills Questionnaire SSS FORM 156.pdf	Form and Instruction
SSS Form 157 Alternative Service Job Data Form SSS FORM 157.pdf	Form and Instruction
SSS Form 160 Request for Overseas Job Assignment SSS FORM 160.pdf	Form and Instruction
SSS Form 163 Employment Verification Form SSS FORM 163.pdf	Form and Instruction
SSS Form 164 Alternative Service Worker Travel Reimbursement Request SSS FORM 164.pdf	Form and Instruction
SSS Form 166 Claim for Reimbursement for Emergency Medical Care SSS FORM 166.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	SSS Form 152	Alternative Service Employment Agreement	SSS FORM 152.pdf	No	Paper Only
Form and Instruction	SSS Form 153	Employer Data Sheet	SSS FORM 153.pdf	No	Paper Only
Form and Instruction	SSS Form 156	Skills Questionnaire	SSS FORM 156.pdf	No	Paper Only
Form and Instruction	SSS Form 157	Alternative Service Job Data Form	SSS FORM 157.pdf	No	Paper Only
Form and Instruction	SSS Form 160	Request for Overseas Job Assignment	SSS FORM 160.pdf	No	Paper Only
Form and Instruction	SSS Form 163	Employment Verification Form	SSS FORM 163.pdf	No	Paper Only
Form and Instruction	SSS Form 164	Alternative Service Worker Travel Reimbursement Request	SSS FORM 164.pdf	No	Paper Only
Form and Instruction	SSS Form 166	Claim for Reimbursement for Emergency Medical Care	SSS FORM 166.pdf	No	Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

Number of Respondents for Small Entity: 1

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	0	0	0	0	0	0
Annual IC Time Burden (Hours)	0	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	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.