Information Collection

INTERNational Connections

IC 191264 under ICR 200911-1405-002 · OMB 1405-0190.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0190 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-5103 INTERNational Connections	Form and Instruction
DS-5103 INTERNagtional_Privacy Policy Screenshot privacypolicy_screenshot.gif	Form and Instruction
DS-5103 PRAStatement_INTERNational_Screenshot PRA_screenshot.gif	Form and Instruction
DS-5103 Login Page FullpageScreenshot.gif	Form and Instruction
DS-5103 Data Entry FINAL INTERNational Connections Screen Shots.docx	Form and Instruction

IC Title:

INTERNational Connections

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?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DS-5103	Data Entry	FINAL INTERNational Connections Screen Shots.docx	Yes	Yes	Fillable Fileable
Form and Instruction	DS-5103	INTERNagtional_Privacy Policy Screenshot	privacypolicy_screenshot.gif	Yes	Yes	Fillable Fileable
Form and Instruction	DS-5103	PRAStatement_INTERNational_Screenshot	PRA_screenshot.gif	Yes	Yes	Fillable Fileable
Form and Instruction	DS-5103	Login Page	FullpageScreenshot.gif	Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	500	500
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.