Geographic Availability Statement

ICR 201208-1545-028

OMB: 1545-0973

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2012-08-17
IC Document Collections
IC ID
Document
Title
Status
17605 Modified
ICR Details
1545-0973 201208-1545-028
Historical Active 200906-1545-024
TREAS/IRS jg-0973-028
Geographic Availability Statement
Extension without change of a currently approved collection   No
Regular
Approved without change 11/01/2012
Retrieve Notice of Action (NOA) 09/17/2012
  Inventory as of this Action Requested Previously Approved
11/30/2015 36 Months From Approved 10/31/2012
500 0 500
84 0 84
0 0 0

The data collected from this form is used by the executive panels responsible for screening internal and external applicants for the SES Candidate Development Program, and other executive position.

US Code: 26 USC 6103 Name of Law: Confidentialityand Disclosure of Returns and Return Information
  
None

Not associated with rulemaking

  77 FR 16586 03/21/2012
77 FR 57189 09/17/2012
No

1
IC Title Form No. Form Name
Geographic Availability Statement 8569 Geographic Availability Statement

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 500 500 0 0 0 0
Annual Time Burden (Hours) 84 84 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$200
No
No
No
No
No
Uncollected
Patricia Bray 202 622-3880

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/17/2012


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