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Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5
Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5
OMB: 1076-0160
IC ID: 11552
OMB.report
DOI/BIA
OMB 1076-0160
ICR 201104-1076-003
IC 11552
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0160 can be found here:
2021-03-29 - Extension without change of a currently approved collection
2018-01-24 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 4432
Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5
Form and Instruction
4432 Verification of Indian Preference for Employment in BIA
Application Form 2011.doc
www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm
Form and Instruction
n/a (Attachment to Family History Chart
Family History Form 2011.doc
www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
25 CFR 5
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
4432
Verification of Indian Preference for Employment in BIA and IHS
Application Form 2011.doc
http://www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm
Yes
No
Paper Only
Form
n/a (Attachment to 4432)
Family History Chart
Family History Form 2011.doc
http://www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
OS-79, General Personnel Records
FR Citation:
64 FR 20010
Number of Respondents:
5,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
5,000
0
0
0
0
5,000
Annual IC Time Burden (Hours)
2,500
0
0
0
0
2,500
Annual IC Cost Burden (Dollars)
6,520
0
0
120
0
6,400
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.