Information Collection

Researcher Responsibilities Acknowledgement

IC 187708 under ICR 201705-0720-001 · OMB 0720-0042.

Documents and Forms

Document Name Document Type
Researcher Responsibilities Form_revisedPAS _ADN_April2017 05.03.2017.doc Other-Acknowledgement Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Researcher Responsibilities Acknowledgement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 32 CFR 219

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Acknowledgement Form			Researcher Responsibilities Form_revisedPAS _ADN_April2017 05.03.2017.doc		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 89	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	89	0	89
Annual IC Time Burden (Hours)	45	0	45
Annual IC Cost Burden (Dollars)	3,130	723	2,407

Documents for IC

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