Information Collection

ICE Mutual Agreement between Government and Employers (IMAGE)

IC 194480 under ICR 201304-1653-004 · OMB 1653-0048.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1653-0048 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 73-028 ICE Mutual Agreement between Government and Employes (IMAGE) Assessment ICE Mutual Agreement between Government and Employers (IMAGE)	Form and Instruction
73-028 ICE Mutual Agreement between Government and Employes (IM ICE Form 73-028.pdf	Form and Instruction

IC Title:

ICE Mutual Agreement between Government and Employers (IMAGE)

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	73-028				Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

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: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	150	150
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.

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