Collection of Required Data Elements to Verify Eligibility

Documents and Forms

Document Name Document Type
OPM-V Screenshots_5.3.2022.pptx Other-Screenshots
OPM-V Screenshots_5.3.2022.pptx Other-Screenshots

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Collection of Required Data Elements to Verify Eligibility	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Screenshots			OPM-V Screenshots_5.3.2022.pptx		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title: Personnel Security Breach Notification and Mitigation Services Records.	FR Citation: 81 FR 8056

Number of Respondents: 50,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	50,000	-950,000	1,000,000
Annual IC Time Burden (Hours)	4,000	-79,333	83,333
Annual IC Cost Burden (Dollars)	156,000	-444,000	600,000

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.