Information Collection

Representations to Implement Appropriations Act Provisions on Felony Convictions and Unpaid Federal Tax Liabilities

IC 205053 under ICR 201212-0704-001 · OMB 0704-0494.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0494 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
part 1 -- ASD(R&E) memorandum.docx	Other-part 1 -- ASD(R&E) memorandum
part 2 -- Attachment 1 to ASD(R&E) memorandum.docx	Other-part 2 -- Attachment 1 to ASD(
part 3 -- Attachment 2 to ASD(R&E) memorandum.docx	Other-part 3 -- Attachment 2 to ASD(

IC Title:

Representations to Implement Appropriations Act Provisions on Felony Convictions and Unpaid Federal Tax Liabilities

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-part 1 -- ASD(R&E) memorandum	part 1 -- ASD(R&E) memorandum.docx	Yes	Yes	Fillable Fileable
Other-part 2 -- Attachment 1 to ASD(R&E) memorandum	part 2 -- Attachment 1 to ASD(R&E) memorandum.docx	Yes	Yes	Fillable Fileable
Other-part 3 -- Attachment 2 to ASD(R&E) memorandum	part 3 -- Attachment 2 to ASD(R&E) memorandum.docx	Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,500

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: 98 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15,000	15,000
Annual IC Time Burden (Hours)	1,250	1,250
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.