Information Collection Request

License for the Use of Personally Identifiable Information Protected Under the E-Government Act of 2002, Title V and the Privacy Act of 1974

ICR 201312-2528-002 · OMB 2528-0297 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Application for Data License Form Modified Available
Justification for Change.docx Justification for No Material/Nonsubstantive Change Uploaded 2013-12-03 Available
Data File Destruction Form.doc Supplementary Document Uploaded 2013-12-03 Available
License for the Use of Personally Identifiable Info Supporting Statement Part A non-substantive change.docx Supporting Statement A Uploaded 2013-12-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
206961 Application for Data License Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2016 09/30/2016 09/30/2016
12 0 12
32 0 30
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Application for Data License N/A Application for Data License

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 12 12 0 0 0 0
Annual Time Burden (Hours) 32 30 0 2 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No