Information Collection

POD Informed Consent Form

IC 227805 under ICR 201805-0960-006 · OMB 0960-0809.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0809 can be found here:

Documents and Forms

Document Name Document Type
Form POD Informed Conse POD Informed Consent Form Form
POD Advanced Letter - Revised.pdf Other-Letter to Recruited Respondent
POD Trifold Brochure - Revised.pdf Other-Informational Brochure
POD Informed Conse Promoting Opportunity Demonstration (POD) Voluntary Part POD Informed Consent Forms - Revised.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	POD Informed Consent Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	POD Informed Consent Form	Promoting Opportunity Demonstration (POD) Voluntary Participation Consent Form	POD Informed Consent Forms - Revised.pdf	No	Paper Only
Other-Letter to Recruited Respondents			POD Advanced Letter - Revised.pdf	No	Paper Only
Other-Informational Brochure			POD Trifold Brochure - Revised.pdf	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	16,500	16,500
Annual IC Time Burden (Hours)	2,750	2,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.