Information Collection

Important Information About Your Appeal, Waiver Rights and Repayment Options - Debt Management System

IC 191691 under ICR 202108-0960-002 · OMB 0960-0779.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
DMS Screenshot.pdf	Other-Intranet Screens (phone call)
DMS Screenshot.pdf	Other-Intranet Screens (phone call)

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.502-.521

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-Intranet Screens (phone call)					Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 166,666

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	166,666	-33,334	200,000
Annual IC Time Burden (Hours)	125,000	75,000	50,000
Annual IC Cost Burden (Dollars)	0	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.

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