Information Collection

Income withholding orders/termination of employment/income status

IC 227080 under ICR 201706-0970-001 · OMB 0970-0154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0154 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Income withholding orders/termination of employment/income status Form
IWO_Instructions.doc Instruction
1 IWO Form IWO Form.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Income withholding orders/termination of employment/income status	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	IWO Form	IWO Form.docx		Yes	Yes	Fillable Printable
Instruction			IWO_Instructions.doc		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,228,320	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11,472,509	11,472,509
Annual IC Time Burden (Hours)	382,417	382,417
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.