Required Additional Information

Required Additional Information (check ROCIS in IC List for this info ---needed for OCIO staff to complete request)

1. Line of Business: General Government

2. Subfunction: Central Records & Statistical Mgt

3. Privacy Act System of Records: Dept 19 Title: _____

4. Federal Registration citation information: _____ Volume _____ Pg. No. _____

5. Number of respondents for small entities: <5%

6. Percentage of respondents reporting electronically: 100%

Please submit all instruments, instructions, correspondences (emails, letters, etc.) to respondents, and scripts as separate documents along with this request document.

Every instrument (survey/form) or correspondence to respondents must have the following displayed –

OMB Control No. 0690-0030

Expiration Date: 07/31/2020

The standard PRA Notwithstanding statement informing respondents of the OMB control number’s legal significance in accordance with 5 CFR 1320.5(b).

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