Information Collection

YTD--12 Month Follow-Up

IC 180545 under ICR 201201-0960-003 · OMB 0960-0687.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
12-Month Pre-Notification Letter.pdf	Other-Notification Letter
12-Month Follow-Up Questionnaire.pdf	Other-Survey

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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
Other-Notification Letter			12-Month Pre-Notification Letter.pdf		No		Paper Only
Other-Survey			12-Month Follow-Up Questionnaire.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,518

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-1,518	1,518
Annual IC Time Burden (Hours)	-1,260	1,260
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.