Information Collection

ORS - State and Local Government

IC 215138 under ICR 201707-1220-001 · OMB 1220-0189.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0189 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 15-1G ORS - State and Local Government	Form
15-1G Establishment Collection Form - Government OMB_ORS_Form_Gov_Form15-1G_2015_0428.docx	Form
4PPD-4G ORS Collection Form - Government Attachment B - Revised ORS Form 4 PPD - 4G.docx	Form
ORS 4 COG 1G ORS - Cognitive Elements Test Recording Form ORS Form 4 COG 1G.docx	Form
ORS_Cog_Field_Test_Introductory_Script.docx Cognitive Elements Test Recruitment Script	IC Document

IC Title:

ORS - State and Local Government

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	15-1G	Establishment Collection Form - Government	OMB_ORS_Form_Gov_Form15-1G_2015_0428.docx	Yes	No	Printable Only
Form	4PPD-4G	ORS Collection Form - Government	Attachment B - Revised ORS Form 4 PPD - 4G.docx	Yes	No	Printable Only
Form	ORS 4 COG 1G	ORS - Cognitive Elements Test Recording Form	ORS Form 4 COG 1G.docx	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,395

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,462	1,462
Annual IC Time Burden (Hours)	2,188	2,188
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Cognitive Elements Test Recruitment Script	ORS_Cog_Field_Test_Introductory_Script.docx	07/28/2017

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