Information Collection

SIPP 2014 Panel

IC 208349 under ICR 201308-0607-001 · OMB 0607-0977.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0977 can be found here:

2016-09-13 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
B-SIPP-105(L1)(2014) Attachment B.pdf	Other-SIPP-105(L1)2014–Director's Le
C-SIPP-105(L1)(SP)(2014) Attachment C.pdf	Other-SIPP-105(L1)(SP)2014–Spanish D
SIPP-105(L2)(2014) revised incentive statement.pdf	Other-SIPP-105(L2)2014–Director's Le
SIPP-105(L3)(2014) revised incentive statement.pdf	Other-SIPP-105(L3)2014–Director's Le
F-SIPP Respondent Rules - Attachment F.pdf	Other-Respondent Rules
G-SIPP Respondent Rules - Attachment G (Spanish).pdf	Other-Respondent Rules (Spanish)
H-SIPP 101_Factsheet [Attachment H].pdf	Other-SIPP Fact Sheet
I-SIPP_Health Insurance_Brochure Attachment I.pdf	Other-SIPP Brochure: Health Insuranc
J-SIPP_Families with Children Brochure Attachment J.pdf	Other-SIPP Brochure: Families with C
K-SIPP_Labor Force_Brochure Attachment K.pdf	Other-SIPP Brochure: Labor Force and
L-SIPP in the News_Attachment L.pub	Other-SIPP In the News
M-sipp_inf1_2014 Attachment M.pdf	Other-SIPP-INF1-2014 Incentive Flyer
N-sipp_inf2_2014 - Attachment N.pdf	Other-SIPP-INF2-2014 Incentive Flyer
O-sipp_pin_2014 Attachment O.pdf	Other-SIPP PIN letter
Items Booklet Items Booklet A-2014 SIPP Items Booklet - Attachment A Part 1.pdf	Form
EHC EHC A-2014 SIPP Items Booklet - Attachment A Part 2 (EHC).pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

SIPP 2014 Panel

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-SIPP-105(L2)2014âDirector's Letter with $20 incentive			SIPP-105(L2)(2014) revised incentive statement.pdf	Yes	Yes	Fillable Fileable
Other-SIPP-105(L3)2014âDirector's Letter with $40 incentive			SIPP-105(L3)(2014) revised incentive statement.pdf	Yes	Yes	Fillable Fileable
Form	Items Booklet	Items Booklet	A-2014 SIPP Items Booklet - Attachment A Part 1.pdf	Yes	Yes	Fillable Fileable
Form	EHC	EHC	A-2014 SIPP Items Booklet - Attachment A Part 2 (EHC).pdf	Yes	Yes	Fillable Fileable
Other-SIPP-105(L1)2014âDirector's Letter			B-SIPP-105(L1)(2014) Attachment B.pdf	Yes	Yes	Fillable Fileable
Other-SIPP-105(L1)(SP)2014âSpanish Director's Letter			C-SIPP-105(L1)(SP)(2014) Attachment C.pdf	Yes	Yes	Fillable Fileable
Other-Respondent Rules			F-SIPP Respondent Rules - Attachment F.pdf	Yes	Yes	Fillable Fileable
Other-Respondent Rules (Spanish)			G-SIPP Respondent Rules - Attachment G (Spanish).pdf	Yes	Yes	Fillable Fileable
Other-SIPP Fact Sheet			H-SIPP 101_Factsheet [Attachment H].pdf	Yes	Yes	Fillable Fileable
Other-SIPP Brochure: Health Insurance			I-SIPP_Health Insurance_Brochure Attachment I.pdf	Yes	Yes	Fillable Fileable
Other-SIPP Brochure: Families with Children			J-SIPP_Families with Children Brochure Attachment J.pdf	Yes	Yes	Fillable Fileable
Other-SIPP Brochure: Labor Force and Employment			K-SIPP_Labor Force_Brochure Attachment K.pdf	Yes	Yes	Fillable Fileable
Other-SIPP In the News			L-SIPP in the News_Attachment L.pub	Yes	Yes	Fillable Fileable
Other-SIPP-INF1-2014 Incentive Flyer for Directorâs Letter $40			M-sipp_inf1_2014 Attachment M.pdf	Yes	Yes	Fillable Fileable
Other-SIPP-INF2-2014 Incentive Flyer for Directorâs Letter $20			N-sipp_inf2_2014 - Attachment N.pdf	Yes	Yes	Fillable Fileable
Other-SIPP PIN letter			O-sipp_pin_2014 Attachment O.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 73,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	73,500	73,500
Annual IC Time Burden (Hours)	73,500	73,500
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.