Information Collection

Substitute Confidential Employment and Financial Disclosure

IC 42238 under ICR 201008-3002-001 · OMB 3002-0003.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3002-0003 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ACUS Form 1 Substitute Confidential Employment and Financial Disclosure	Form
ACUS Form 1 ACUS Public Member Confidential Employment and Financial Member Financial Disclosure Form 9-15-2010.doc	Form

IC Title:

Substitute Confidential Employment and Financial Disclosure

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	ACUS Form 1	ACUS Public Member Confidential Employment and Financial Disclosure Report	Member Financial Disclosure Form 9-15-2010.doc		Yes	Yes	Printable Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	540	540	-100	100
Annual IC Time Burden (Hours)	135	135	-29	29
Annual IC Cost Burden (Dollars)	0	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.