Information Collection

Panelist Profile Form

IC 216826 under ICR 201506-3135-001 · OMB 3135-0098.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3135-0098 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3135-0098 Panelist Profile Form	Form and Instruction
3135-0098 Panelist Profile Form Panelist Profile Form and Instructions_2015.docx	Form and Instruction

IC Title:

Panelist Profile Form

Agency IC Tracking Number:

IC Status: New

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	3135-0098	Panelist Profile Form	Panelist Profile Form and Instructions_2015.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title: 5 U.S.C. 552a

FR Citation: 80 FR 19357

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	50	50
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.