Information Collection

Personal Conflict of Interest Mitigation Plan/Waiver Request; FAR Subpart and Section Affected 3.11 and 52.203-16

IC 213755 under ICR 201411-9000-002 · OMB 9000-0183.

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Information Collection (IC) Details

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IC Title:	Personal Conflict of Interest Mitigation Plan/Waiver Request; FAR Subpart and Section Affected 3.11 and 52.203-16	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 48 CFR 3.11 48 CFR 52.203-16

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Supply Chain Management

Subfunction: Services Acquisition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 94	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	94	94
Annual IC Time Burden (Hours)	1,880	1,880
Annual IC Cost Burden (Dollars)	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.