Information Collection

Preventing Personal Conflicts of Interest--Mitigation Plan or Waiver Requests

IC 266290 under ICR 202403-9000-004 · OMB 9000-0018.

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Information Collection (IC) Details

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IC Title:	Preventing Personal Conflicts of Interest--Mitigation Plan or Waiver Requests	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 48 CFR FAR 52.203-16 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Supply Chain Management

Subfunction: Goods Acquisition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	43,500	43,500

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