OMB
.report
Search
Application for Employment as a Locally Employed Staff or Family Member
Application for Employment as a Locally Employed Staff or Family Member
OMB: 1405-0189
IC ID: 190750
OMB.report
STATE/AFA
OMB 1405-0189
ICR 202202-1405-001
IC 190750
( )
Documents and Forms
Document Name
Document Type
Form DS-174
Application for Employment as a Locally Employed Staff or Family Member
Form and Instruction
Screenshots 2019.docx
Other-Screenshots
Screenshots 2019.docx
Other-Screenshots
DS-174 Application for Employment as a Locally Employed Staff o
DS-0174.pdf
Form and Instruction
DS-174 Application for Employment as a Locally Employed Staff o
DS-0174.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Employment as a Locally Employed Staff or Family Member
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
DS-174
Application for Employment as a Locally Employed Staff or Family Member
DS-0174.pdf
Yes
Yes
Fillable Fileable
Other-Screenshots
Screenshots 2019.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,000,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
90 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,000,000
0
0
0
0
1,000,000
Annual IC Time Burden (Hours)
750,000
0
0
0
0
750,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.