Information Collection Request

Records Modification Form (FD-1115)

ICR 201710-1110-007 · OMB 1110-0068 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1110-0068 Records Modification Form (FD-1115) Form and Instruction Modified Available
1110-0068 Signed 83I.pdf Supplementary Document Uploaded 2018-11-29 Available
FD-1115_Title 28 CFR Section 0.85 Law.pdf Supplementary Document Uploaded 2015-02-25 Available
FD-1115_Title 28 CFR Section 20.33 Law.pdf Supplementary Document Uploaded 2015-02-25 Available
FD-1115_Title 28 CFR Section 50.12 Law.pdf Supplementary Document Uploaded 2015-02-25 Available
FD-1115_Paperwork Certification.docx Supplementary Document Uploaded 2015-02-25 Available
FD-1115_83I.pdf Supplementary Document Uploaded 2015-02-25 Available
1110-0068 FD-1115 Supporting Statement.docx Supporting Statement A Uploaded 2018-11-29 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
215286 Records Modification Form (FD-1115) 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
119,293 0 132,070
19,882 0 22,011
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Records Modification Form (FD-1115) 1110-0068 Records Modification 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 119,293 132,070 0 -12,777 0 0
Annual Time Burden (Hours) 19,882 22,011 0 -2,129 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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