Information Collection

Background Investigations for Child Care Workers, GSA Form 176

IC 190281 under ICR 201204-3090-001 · OMB 3090-0287.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3090-0287 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 176 Background Investigations for Child Care Workers, GSA Form 176	Form and Instruction
176 BASIC NATIONAL AGENCY CHECK CRIMINAL HISTORY GSA Form 176-OMB Control No 3090-0287-Rev-10-16-2012.pdf www.gsa.gov	Form and Instruction

IC Title:

Background Investigations for Child Care Workers, GSA Form 176

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form and Instruction	176	BASIC NATIONAL AGENCY CHECK CRIMINAL HISTORY	GSA Form 176-OMB Control No 3090-0287-Rev-10-16-2012.pdf	www.gsa.gov	Yes	No	Fillable Printable

Line of Business: Supply Chain Management

Subfunction: Services Acquisition

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,060

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3,060	3,060
Annual IC Time Burden (Hours)	1,530	1,530
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.