Information Collection

EVS One-Time Registration

IC 184379 under ICR 201204-0960-019 · OMB 0960-0660.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0660 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
EVS One-Time Registration	Form
EVS Individual Privacy Attestation.pdf	Other-Privacy Attestation
EVS Third Party Privacy Attestation.pdf	Other-Privacy Attestation
EVS Registration Form EVS Registration Form.pdf	Form

IC Title:

EVS One-Time Registration

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 401.45

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	EVS Registration Form	EVS Registration Form.pdf	Yes	No	Printable Only
Other-Privacy Attestation			EVS Individual Privacy Attestation.pdf	Yes	No	Printable Only
Other-Privacy Attestation			EVS Third Party Privacy Attestation.pdf	Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-50	50
Annual IC Time Burden (Hours)	-2	2
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.