Information Collection

Death Gratuity Information Sheet

IC 259673 under ICR 202212-1651-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Death Gratuity Information Sheet	Form
Death Gratuity Information Sheet 1651-0NEW Death Gratuity Information Sheet.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form	N/A	Death Gratuity Information Sheet	1651-0NEW Death Gratuity Information Sheet.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: SORN OPM\GOVT-9

FR Citation: 78 FR 60331

Number of Respondents: 33

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	33	33
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

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.