Information Collection

Claim for Relocation Payments - Residential

IC 11562 under ICR 202111-1084-001 · OMB 1084-0010.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1084-0010 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DI-381 Claim for Relocation Payments - Residential	Form and Instruction
DI-381 Claim for Relocation Payments - Residential - Main DI-381_Res_7-2020.pdf	Form and Instruction
DI-381 Claim for Relocation Payments - Residential - Schedule A DI-381_Res_ScheduleA_7-2020.pdf	Form and Instruction
DI-381 Claim for Relocation Payments - Residential - Schedule B DI-381_Res_ScheduleB_7-2020.pdf	Form and Instruction
DI-381 Claim for Relocation Payments - Residential - Schedule C DI-381_Res_ScheduleC_7-2020.pdf	Form and Instruction
DI-381 Claim for Relocation Payments - Residential - Schedule D DI-381_Res_ScheduleD_7-2020.pdf	Form and Instruction

IC Title:

Claim for Relocation Payments - Residential

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DI-381	Claim for Relocation Payments - Residential - Main	DI-381_Res_7-2020.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DI-381	Claim for Relocation Payments - Residential - Schedule A	DI-381_Res_ScheduleA_7-2020.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DI-381	Claim for Relocation Payments - Residential - Schedule B	DI-381_Res_ScheduleB_7-2020.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DI-381	Claim for Relocation Payments - Residential - Schedule C	DI-381_Res_ScheduleC_7-2020.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	DI-381	Claim for Relocation Payments - Residential - Schedule D	DI-381_Res_ScheduleD_7-2020.pdf	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Property Management

Privacy Act System of Records

Title: Interior Relocation Assistance Program Records, DOI-02

FR Citation: 73 FR 22125

Number of Respondents: 19

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	19	19
Annual IC Time Burden (Hours)	16	16
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.