Information Collection

Applicant Background Survey

IC 11577 under ICR 200903-1091-001 · OMB 1091-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1091-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DI 1935 Applicant Background Survey	Form and Instruction
DI 1935 Applicant Background Survey Applicant Background Survey FORM.doc htto://www.doi.gov/diversity	Form and Instruction

IC Title:

Applicant Background Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DI 1935	Applicant Background Survey	Applicant Background Survey FORM.doc	htto://www.doi.gov/diversity	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: Interior Personnel Records, DOI--79

FR Citation: 64 FR 20010

Number of Respondents: 335,820

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	335,820	-199,340	535,160
Annual IC Time Burden (Hours)	11,194	-15,564	26,758
Annual IC Cost Burden (Dollars)	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.