Information Collection

Year 1 Survey

IC 220102 under ICR 201412-1210-007 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Internet IPS Basel Internet IPS Baseline Interview Year 1 Survey	Form and Instruction
Form Internet IPS Follo Internet IPS Follow-Up Interview Year 1 Survey	Form and Instruction
Form Mail/Telephone IPS Mail/Telephone IPS Interview Year 1 Survey	Form and Instruction
Form Internet AIS Inter Internet AIS Interview Year 1 Survey	Form and Instruction
Form Mail/Telephone AIS Mail/Telephone AIS Interview Year 1 Survey	Form and Instruction
Internet IPS Basel Internet IPS Baseline Interview Appendix 8 - Road to Retirement 4_10_2017.docx	Form and Instruction
Internet IPS Follo Internet IPS Follow-Up Interview Appendix 9 - Road to Retirement 4_10_2017.docx	Form and Instruction
Mail/Telephone IPS Mail/Telephone IPS Interview Appendix 10 - Road to Retirement 4_10_2017.pdf	Form and Instruction
Internet AIS Inter Internet AIS Interview Appendix 11 - Road to Retirement 4_10_2017.docx	Form and Instruction
Mail/Telephone AIS Mail/Telephone AIS Interview Appendix 12 - Road to Retirement 4_10_2017.pdf	Form and Instruction

IC Title:

Year 1 Survey

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.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Internet IPS Baseline Interview	Yes	Yes	Fillable Fileable
Form and Instruction	Internet IPS Follow-Up Interview	Yes	Yes	Fillable Fileable
Form and Instruction	Mail/Telephone IPS Interview	No		Paper Only
Form and Instruction	Internet AIS Interview	Yes	Yes	Fillable Fileable
Form and Instruction	Mail/Telephone AIS Interview	No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 89 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,314	8,314
Annual IC Time Burden (Hours)	4,660	4,660
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.

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