Information Collection

Revoking Authorization

IC 226074 under ICR 202003-0960-004 · OMB 0960-0807.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0807 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
BBA 824 Intranet Final Screen Package OMB version 05182017.docx	Other-Internet Screens
iClaim Screen for OMB 021517 (3).docx	Other-Payroll Data Release Form Scre

IC Title:

Revoking Authorization

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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
Other-Internet Screens			BBA 824 Intranet Final Screen Package OMB version 05182017.docx		Yes	Yes	Fillable Fileable Signable
Other-Payroll Data Release Form Screen			iClaim Screen for OMB 021517 (3).docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 191,673

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-191,673	191,673
Annual IC Time Burden (Hours)	-31,946	31,946
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.