Mid-Term Self-Identification

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-0922 can be found here:

Documents and Forms

Document Name Document Type
Screenshot for revised OMB 3060-0922.docx Other-Screen Shots

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mid-Term Self-Identification	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screen Shots			Screenshot for revised OMB 3060-0922.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13,183	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	13,183	12,002	1,181
Annual IC Time Burden (Hours)	264	-327	591
Annual IC Cost Burden (Dollars)	0	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.