Customer Data Worksheet Request for SCIMS Change

Customer Data Worksheet Request for SCIMS Record Change

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0560-0265 can be found here:

Documents and Forms

Document Name Document Type
Form AD 2047 Customer Data Worksheet Request for SCIMS Change Form and Instruction
AD 2047 Customer Data Worksheet Request for SCIMS Change AD2047_090804V02.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Customer Data Worksheet Request for SCIMS Change	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	AD 2047	Customer Data Worksheet Request for SCIMS Change	AD2047_090804V02.docx		Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51,750	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	51,750	0	51,750
Annual IC Time Burden (Hours)	8,798	-15,525	24,323
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.