Information Collection

Substitute Confidential Employment and Financial Disclosure

IC 42238 under ICR 201101-3002-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Substitute Confidential Employment and Financial Disclos Member Financial Disclosure Form 4-25-2011.docx	Form
ACUS Form 1W Substitute Confidential Employment and Financial Disclos Financial Disclosure--Web Format 5-2-2011.pdf www.acus.gov/foia/financial-disclosure-certification/	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	Substitute Confidential Employment and Financial Disclosure Form	Member Financial Disclosure Form 4-25-2011.docx		Yes	No	Printable Only
Form	ACUS Form 1W	Substitute Confidential Employment and Financial Disclosure	Financial Disclosure--Web Format 5-2-2011.pdf	http://www.acus.gov/foia/financial-disclosure-certification/	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	450	-90	540
Annual IC Time Burden (Hours)	113	-22	135
Annual IC Cost Burden (Dollars)	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.