Information Collection

Employment Verification Form

IC 190908 under ICR 202205-1810-002 · OMB 1810-0698.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1810-0698 can be found here:

Documents and Forms

Document Name Document Type
Employment Verification Form Form and Instruction
Employment Verification Form 1810-0698 PD_employer_form 04182019.docx Form and Instruction
Employment Verification Form 1810-0698 PD_employer_form 04182019.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Employment Verification Form	Agency IC Tracking Number:	ED-2016-ICCD-0012

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 34 CFR 263

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Employment Verification Form	1810-0698 PD_employer_form 04182019.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title: Indian Education Individual Reporting on Regulatory Compliance Related to the Indian Education Professional Development programs Service Obligation and GPRA	FR Citation: 76 FR 4334

Number of Respondents: 920	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-920	920
Annual IC Time Burden (Hours)	-304	304
Annual IC Cost Burden (Dollars)	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.