Information Collection

Term and Condition Notification of Harassment Form

IC 247340 under ICR 202105-2700-001 · OMB 2700-0185.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screenshot for Harassment Reporting.docx nasa-my.sharepoint.com/:w:/g/personal/wkeeter_ndc_nasa_gov/ES9kZzVHhH9BgLaTa3YuNigBFTQIEnVP2iMn4fEUJwuVCg?e=97PQeE	Other-web form
Screenshot for Harassment Reporting.docx nasa-my.sharepoint.com/:w:/g/personal/wkeeter_ndc_nasa_gov/ES9kZzVHhH9BgLaTa3YuNigBFTQIEnVP2iMn4fEUJwuVCg?e=97PQeE	Other-web form
Text Harassment Reporting.docx nasa-my.sharepoint.com/:w:/g/personal/wkeeter_ndc_nasa_gov/ES9kZzVHhH9BgLaTa3YuNigBFTQIEnVP2iMn4fEUJwuVCg?e=97PQeE	Other-web form
Text Harassment Reporting.docx nasa-my.sharepoint.com/:w:/g/personal/wkeeter_ndc_nasa_gov/ES9kZzVHhH9BgLaTa3YuNigBFTQIEnVP2iMn4fEUJwuVCg?e=97PQeE	Other-web form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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-web form			Screenshot for Harassment Reporting.docx	https://nasa-my.sharepoint.com/:w:/g/personal/wkeeter_ndc_nasa_gov/ES9kZzVHhH9BgLaTa3YuNigBFTQIEnVP2iMn4fEUJwuVCg?e=97PQeE	Yes	Yes	Fillable Fileable
Other-web form			Text Harassment Reporting.docx	https://nasa-my.sharepoint.com/:w:/g/personal/wkeeter_ndc_nasa_gov/ES9kZzVHhH9BgLaTa3YuNigBFTQIEnVP2iMn4fEUJwuVCg?e=97PQeE	Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 550

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	550	550
Annual IC Time Burden (Hours)	2,200	2,200
Annual IC Cost Burden (Dollars)	110,000	110,000

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.