Information Collection

b) 20 CFR 411.145 & 411.325 - Requesting Ticket Unassignments

IC 184449 under ICR 202403-0960-004 · OMB 0960-0644.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
DemoDeck.pptx	Other-screens
DemoDeck.pptx	Other-screens
Ticket Unassignment Form (revised).pdf	Other-screens
Ticket Unassignment Form (revised).pdf	Other-screens
Ticket Unassignment Form (curremt).pdf Ticket Unassignment Form	IC Document
Ticket Unassignment Form (curremt).pdf Ticket Unassignment Form	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 411.325 20 CFR 411.145

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-screens					Yes	Yes	Fillable Fileable
Other-screens					Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,494

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,494	2,494
Annual IC Time Burden (Hours)	624	624
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Ticket Unassignment Form		01/18/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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