Information Collection Request

Rap Back Services Form (1-796)

ICR 201710-1110-006 · OMB 1110-0067 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1-796 Rap Back Services Form 1-796 Form and Instruction Modified Available
1-796 MOU.pdf Supplementary Document Uploaded 2018-10-30 Available
1-796 Law.pdf Supplementary Document Uploaded 2018-10-30 Available
Updated Rap Back 83I (Fillable).pdf Supplementary Document Uploaded 2018-10-31 Available
1-796 Certification.pdf Supplementary Document Uploaded 2018-10-30 Available
Supporting Statement A.docx Supporting Statement A Uploaded 2018-10-31 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
215135 Rap Back Services Form 1-796 Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2022 36 Months From Approved 02/28/2019
12 0 6,000
1 0 300
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Rap Back Services Form 1-796 1-796 Rap Back Services Form

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 12 6,000 0 -5,988 0 0
Annual Time Burden (Hours) 1 300 0 -299 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No