Information Collection

Part 1239 Clause 1252.239-75

IC 251389 under ICR 202209-2105-002 · OMB 2105-0579.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0579 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2105-AE26 PRA Group 3 IC Instrument - 07SEP2022.docx	Instruction
2105-AE26 PRA Group 3 IC Instrument - 07SEP2022.docx	Instruction

IC Title:

Part 1239 Clause 1252.239-75

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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
Instruction			2105-AE26 PRA Group 3 IC Instrument - 07SEP2022.docx		No		Paper Only

Line of Business: Supply Chain Management

Subfunction: Services Acquisition

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 311

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	622	622
Annual IC Time Burden (Hours)	622	622
Annual IC Cost Burden (Dollars)	17,696	17,696

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.