Information Collection

Baseline Information Form

IC 227203 under ICR 201706-1290-001 · OMB 1290-0014.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Baseline Information Form_updated.docx	Other-Baseline information
TechHire Informed Consent Form_updated_1-17-2018.docx Informed Consent form	IC Document

IC Title:

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Baseline information			Baseline Information Form_updated.docx		No		Printable Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	600	600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Informed Consent form	TechHire Informed Consent Form_updated_1-17-2018.docx	01/24/2018

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