Information Collection Request

FOCI Outside Director/Proxy Holder Nomination Questionnaires

ICR 202210-0705-004 · OMB 0705-0005 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
0705-0005_SSA_12.29.2022.docx Supporting Statement A Uploaded 2022-12-29 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
257352 Outside Director/Proxy Holder Nominee Package Other-Questionnaire New
238280 Group Assessment Form Other- Removed
238279 Peer Evaluation Form Other- Removed
238275 Self-Assessment Form Other- Removed
238273 Outside Director/Proxy Holder Nominating Official Package Other-Questionnaire Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2026 36 Months From Approved 02/28/2023
250 0 9,875
188 0 7,494
29,661 0 998,567





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Group Assessment Form
Outside Director/Proxy Holder Nominating Official Package
Outside Director/Proxy Holder Nominee Package
Peer Evaluation Form
Self-Assessment Form

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 250 9,875 0 -9,749 124 0
Annual Time Burden (Hours) 188 7,494 0 -7,399 93 0
Annual Cost Burden (Dollars) 29,661 998,567 0 -974,522 5,616 0


Reginfo record details
  No