Self-Monitoring Questionnaire for Insurance and Finance Projects

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3420-0019 can be found here:

Documents and Forms

Document Name Document Type
Form OPIC-162 Self-Monitoring Questionnaire for Insurance and Finance Projects Form and Instruction
OPIC-162 Self-Monitoring Questionnaire for Insurance and Finance Revised-OPIC 162 -SMQ-2012.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Self-Monitoring Questionnaire for Insurance and Finance Projects	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OPIC-162	Self-Monitoring Questionnaire for Insurance and Finance )Projedts	Revised-OPIC 162 -SMQ-2012.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 450	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	450	100	350
Annual IC Time Burden (Hours)	1,800	-1,350	3,150
Annual IC Cost Burden (Dollars)	94,500	94,500	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.