Information Collection

FEGLI Implementation Questionnaire for Tribal Employers

IC 208748 under ICR 201309-3206-001 · OMB 3206-0260.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEGLI FEGLI Implementation Questionnaire for Tribal Employers	Form and Instruction
FEGLI FEGLI Implementation Questionnaire for Tribal Employers FEGLI Tribal Questionnaire_FINAL.pdf	Form and Instruction

IC Title:

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FEGLI	FEGLI Implementation Questionnaire for Tribal Employers	FEGLI Tribal Questionnaire_FINAL.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 700

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	700	700
Annual IC Time Burden (Hours)	58	58
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.