Information Collection Request

Grantee Reporting Form -Rehabilitation Services Administration (RSA) Annual Payback Report

ICR 201809-1820-001 · OMB 1820-0617 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Employers: Employment Verification Record Form and Instruction New Available
Scholars: Scholar Training and Employment Record Form and Instruction New Available
Grantees: Scholar Record Form and Instruction Modified Available
RSA PIMS Supporting_Statement 1820-0617.docx Supporting Statement A Uploaded 2018-11-19 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
232924 Employers: Employment Verification Record Form and Instruction New
232923 Scholars: Scholar Training and Employment Record Form and Instruction New
190462 Grantees: Scholar Record Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2022 36 Months From Approved 02/28/2019
11,790 0 350
4,858 0 350
0 0 0





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 11,790 350 0 11,440 0 0
Annual Time Burden (Hours) 4,858 350 0 4,508 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No