Information Collection

Survey of UI Recipients

IC 200108 under ICR 201212-1225-001 · OMB 1225-0089.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
UCP_OMB_AppendixA_final_20121012.pdf	Other-Survey
UCP_OMB_AppendixG_final_20121012.pdf Appendix G--Respondent Mailings	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Other-Survey			UCP_OMB_AppendixA_final_20121012.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	1,200	1,200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix G--Respondent Mailings	UCP_OMB_AppendixG_final_20121012.pdf	12/03/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.