Information Collection

Certification By School Official

IC 13706 under ICR 201909-1240-001 · OMB 1240-0031.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0031 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CM-981 Certification By School Official	Form
CM-981 Certification by School Official 2020.03.18 CM-981.docx .dol.gov/owcp/regs/compliance/cm-981	Form
30 USC 901-902.pdf 30USC901 - 902	IC Document
725.209 to 725.218.pdf OWCP-2	IC Document

IC Title:

Certification By School Official

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 725.209-218

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	CM-981	Certification by School Official	2020.03.18 CM-981.docx	http://.dol.gov/owcp/regs/compliance/cm-981	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: Privacy Act System of Records, DOL/OWCP-2

FR Citation: 67 FR 16869

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	100	-393	493
Annual IC Time Burden (Hours)	17	-65	82
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
30USC901 - 902	30 USC 901-902.pdf	02/07/2007
OWCP-2	725.209 to 725.218.pdf	09/09/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.