SSS Form 404 - Potential Board Member Information

Potential Board Member Information

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3240-0005 can be found here:

Documents and Forms

Document Name Document Type
Form SSS Form 404 SSS Form 404 - Potential Board Member Information Form and Instruction
SSS Form 404 Potential Board Member Information SSS Form 404 & Instruction Sheets - FEBRUARY 2011 FINAL VERSION July 27, 2011 per OMB.doc Form and Instruction

Information Collection (IC) Details

IC Title:	SSS Form 404 - Potential Board Member Information	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

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	SSS Form 404	Potential Board Member Information	SSS Form 404 & Instruction Sheets - FEBRUARY 2011 FINAL VERSION July 27, 2011 per OMB.doc		No		Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: SSS-7 - Uncompensated Personnel Records	FR Citation: 65 FR 184

Number of Respondents: 1,077	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,077	1,077
Annual IC Time Burden (Hours)	269	269
Annual IC Cost Burden (Dollars)	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.