Information Collection

Confidential Financial Disclosure Form

IC 181374 under ICR 201711-2090-001 · OMB 2090-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2090-0029 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3110-48 Confidential Financial Disclosure Form	Form and Instruction
3110-48 Confidential Financial Disclosure Form for Special Gover 2260.06 Form 3110-48.pdf www.epa.gov/sap/confidential-financial-disclosure-form-environmental-protection-agency-special-government	Form and Instruction

IC Title:

Confidential Financial Disclosure Form

Agency IC Tracking Number:

2260.06

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 2634.903

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
Form and Instruction	3110-48	Confidential Financial Disclosure Form for Special Government Employees	2260.06 Form 3110-48.pdf	https://www.epa.gov/sap/confidential-financial-disclosure-form-environmental-protection-agency-special-government	Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	500	250	250
Annual IC Time Burden (Hours)	500	250	250
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.