Information Collection

SSS Form 404 - Potential Board Member Information

IC 197670 under ICR 201404-3240-007 · OMB 3240-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3240-0005 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSS Form 404 SSS Form 404 - Potential Board Member Information	Form and Instruction
SSS Form 404 Potential Board Member Information SSS Form 404 & Instruction Sheets - FEBRUARY 2011 FINAL VERSION July 27, 2011 per OMB.doc	Form and Instruction

IC Title:

SSS Form 404 - Potential Board Member Information

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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	SSS Form 404	Potential Board Member Information	SSS Form 404 & Instruction Sheets - FEBRUARY 2011 FINAL VERSION July 27, 2011 per OMB.doc		No		Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title: SSS-7 - Uncompensated Personnel Records

FR Citation: 65 FR 184

Number of Respondents: 1,077

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-1,077	1,077
Annual IC Time Burden (Hours)	-269	269
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.