Information Collection

Supplemental Disability Report

IC 28343 under ICR 201102-2900-007 · OMB 2900-0129.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0129 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FL 29-30A Supplemental Disability Report	Form
FL 29-30A Supplemental Disability Report fl29-30a.pdf	Form

IC Title:

Supplemental Disability Report

Agency IC Tracking Number:

2900-0129

Is this a Common Form? No

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FL 29-30A	Supplemental Disability Report	fl29-30a.pdf		No		Paper Only

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,570

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	Previously Approved
Annual Number of Responses for this IC	6,570	6,570
Annual IC Time Burden (Hours)	548	548
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.