Information Collection

Applicant Background Survey

IC 11577 under ICR 201204-1091-001 · OMB 1091-0001.

Documents and Forms

Document Name Document Type
Form DI 1935 Applicant Background Survey Form and Instruction
DI 1935 Applicant Background Survey DI-1935-Applicant-Background-Survey-form 7-31-12.pdf www.doi.gov/pmb/eeo/upload/DI-1935-Applicant-Background-Survey-form.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Applicant Background Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	DI 1935	Applicant Background Survey	DI-1935-Applicant-Background-Survey-form 7-31-12.pdf	http://www.doi.gov/pmb/eeo/upload/DI-1935-Applicant-Background-Survey-form.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: Interior Personnel Records, DOI--79	FR Citation: 64 FR 20010

Number of Respondents: 366,680	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	366,680	30,860	335,820
Annual IC Time Burden (Hours)	6,111	-5,083	11,194
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.