Information Collection Request

Fidelity Bonding Issuance

ICR 202301-1205-001 · OMB 1205-0541 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
FBDG TEGL_10-20_Funding.pdf Supplementary Document Uploaded 2023-01-10 Repair queued
1205-0541 Supporting Statement - CLEAN 4.423.docx Supporting Statement A Uploaded 2023-04-04 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
240164 State Bonding Coordinators or Designated AJC Counselors - Recordkeeping Modified
238575 State Bonding Coordinators or AJC Counselors -- Data Collection and Submission Other-Fidelity Bonding Issuance Form Modified
238574 Employers Modified
238573 Placed Individuals Modified

ICR Details

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table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2026 36 Months From Approved 05/31/2023
32,000 0 24,000
2,400 0 1,800
0 0 0





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4
table that charts list of burden
IC Title Form No. Form Name
Employers
Placed Individuals
State Bonding Coordinators or AJC Counselors -- Data Collection and Submission
State Bonding Coordinators or Designated AJC Counselors - Recordkeeping

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 32,000 24,000 0 0 8,000 0
Annual Time Burden (Hours) 2,400 1,800 0 0 600 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


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