Information Collection

FSR 281 mobile Template Dept of State, 282 DHS Questionnaire New Model

IC 191236 under ICR 201101-1090-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form FSR 282 FSR 281 mobile Template Dept of State, 282 DHS Questionnaire New Model	Form
FSR 281 Mobile Template Dept of State 281 Mobile Template Dept of State 11-6-09.xls	Form
FSR 282 DHS Questionnaire New Model 282 DHS Questionnaire Finalized New Model 11-6-09.xls	Form
FSR 283 Current Master Element List Current Master Element List 11-17-09 for OMB Approval.xls	Form

IC Title:

FSR 281 mobile Template Dept of State, 282 DHS Questionnaire New Model

Agency IC Tracking Number:

FSR 281, FSR 282

IC Status: Unchanged

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	FSR 282	DHS Questionnaire New Model	282 DHS Questionnaire Finalized New Model 11-6-09.xls	Yes	Yes	Fillable Fileable
Form	FSR 283	Current Master Element List	Current Master Element List 11-17-09 for OMB Approval.xls	Yes	Yes	Fillable Fileable
Form	FSR 281	Mobile Template Dept of State	281 Mobile Template Dept of State 11-6-09.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: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	417	417
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.