Information Collection Request

Investigation of Claim for Possible Days of Employment

ICR 201401-3220-007 · OMB 3220-0196 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form ID-5S(SUP) (10-07) Investigation of Claim for Possible Days of Employment Form Modified Available
3220-0196.doc Supporting Statement A Uploaded 2014-02-27 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
34016 Investigation of Claim for Possible Days of Employment Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2017 36 Months From Approved 03/31/2014
55 0 80
9 0 13
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Investigation of Claim for Possible Days of Employment ID-5S (10-07), ID-5S(SUP) (10-07) Report of Case for Which All Days were Claimed During a Month Credited Per an Adjustment Report ,   ID-5S(SUP) Transmittal Letter

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 55 80 0 -25 0 0
Annual Time Burden (Hours) 9 13 0 -4 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No