Information Collection

Group Assessment Form

IC 238280 under ICR 202210-0705-004 · OMB 0705-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0705-0005 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FOCI Board Group Assessment Form (Aug 8 2019).pdf	Other-
FOCI Board Group Assessment Form (Aug 8 2019).pdf	Other-

IC Title:

Group Assessment Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

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
Other-			FOCI Board Group Assessment Form (Aug 8 2019).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-350	350
Annual IC Time Burden (Hours)	-350	350
Annual IC Cost Burden (Dollars)	-46,638	46,638

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.