Information Collection

Notice of Recurrence

IC 13870 under ICR 202310-1240-002 · OMB 1240-0009.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CA-2a Notice of Recurrence	Form and Instruction
CA-2a Notice of Recurrence ca-2a updated 2023.pdf www.dol.gov/owcp/regs/compliance/ca-2a.pdf	Form and Instruction
CA-2a Notice of Recurrence ca-2a updated 2023.pdf www.dol.gov/owcp/regs/compliance/ca-2a.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 10.104

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 and Instruction	CA-2a	Notice of Recurrence	ca-2a updated 2023.pdf	http://www.dol.gov/owcp/regs/compliance/ca-2a.pdf	Yes	Yes	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: DOL/GOVT-1

FR Citation: 81 FR 47418

Number of Respondents: 149

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 39 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	149	16	133
Annual IC Time Burden (Hours)	75	8	67
Annual IC Cost Burden (Dollars)	63	-6	69

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.