Information Collection

POD Baseline Survey

IC 227810 under ICR 201901-0960-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
POD Baseline Survey	Form and Instruction
Promoting Opportunity Demonstration (POD) Baseline Quest POD Baseline Survey - Revised.pdf	Form and Instruction

IC Title:

POD Baseline Survey

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:

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	N/A	Promoting Opportunity Demonstration (POD) Baseline Questionnaire	POD Baseline Survey - 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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	16,500	16,500
Annual IC Time Burden (Hours)	5,500	5,500
Annual IC Cost Burden (Dollars)	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.