Information Collection

YTD--Baseline Questionnaire

IC 9741 under ICR 200901-0960-012 · OMB 0960-0687.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0687 can be found here:

Documents and Forms

Document Name Document Type
Baseline Questionnaire.pdf Other-Survey
Baseline Pre-Notification Letter.pdf Other-Notification Letter

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	YTD--Baseline Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			Baseline Questionnaire.pdf		Yes	Yes	Fillable Fileable
Other-Notification Letter			Baseline Pre-Notification Letter.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,895	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,895	-636	2,531
Annual IC Time Burden (Hours)	1,042	-350	1,392
Annual IC Cost Burden (Dollars)	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.