Information Collection

Employment Verification Form

IC 190908 under ICR 200909-1810-002 · OMB 1810-0698.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1810-0698 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Employment Verification Form	Form and Instruction
Employment Verification Form IE PD Employment Verifi Form Ins 3.doc	Form and Instruction

IC Title:

Employment Verification Form

Agency IC Tracking Number:

04082

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Employment Verification Form	IE PD Employment Verifi Form Ins 3.doc		No		Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,020

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,020	1,020
Annual IC Time Burden (Hours)	1,020	1,020
Annual IC Cost Burden (Dollars)	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.