Information Collection

283 Master, 285 DHS CIS eVfy, 286 HHS ONC, 287 CQs

IC 191492 under ICR 200905-1090-001 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Document Name Document Type
Form 285 eVfy 283 Master, 285 DHS CIS eVfy, 286 HHS ONC, 287 CQs Form
285 eVfy 285 DHS CIS eVerify Questionnaire 285 DHS CIS eVerify Questionnaire FINAL 12-4-09.xls Form
283 Master 283 Master Questions List as of 11-17-09 283 Master Questions List as of 11-17-09.xls Form
286 HHS ONC 286 HHS ONC Questions 286 HHS ONC_Questions_FINAL 12-4-09.xls Form
287 Custom 287 Custom Questions from 11-16-09 to 12-4-09 287 Custom Questions for OMB 11-16-09 to 12-4-09.xls Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	283 Master, 285 DHS CIS eVfy, 286 HHS ONC, 287 CQs	Agency IC Tracking Number:	283, Master, 285 eVfy, 286 HHS ONC, 287 CQs

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	285 eVfy	285 DHS CIS eVerify Questionnaire	285 DHS CIS eVerify Questionnaire FINAL 12-4-09.xls	Yes	Yes	Fillable Fileable
Form	283 Master	283 Master Questions List as of 11-17-09	283 Master Questions List as of 11-17-09.xls	Yes	Yes	Fillable Fileable
Form	286 HHS ONC	286 HHS ONC Questions	286 HHS ONC_Questions_FINAL 12-4-09.xls	Yes	Yes	Fillable Fileable
Form	287 Custom	287 Custom Questions from 11-16-09 to 12-4-09	287 Custom Questions for OMB 11-16-09 to 12-4-09.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 Agency Discretion
Annual Number of Responses for this IC	20,000	20,000
Annual IC Time Burden (Hours)	833	833
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.