Information Collection

RETAIN Enrollee Surveys Round 2 (respondents)

IC 266923 under ICR 202404-0960-002 · OMB 0960-0821.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
APPENDIX B - ENROLLEE SURVEY INSTRUMENTS (Round 2).pdf	Other-ENROLLEE SURVEY INSTRUMENTS (R
APPENDIX B - ENROLLEE SURVEY INSTRUMENTS (Round 2).pdf	Other-ENROLLEE SURVEY INSTRUMENTS (R
APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2).pdf	Other-ENROLLEE SURVEY MAILINGS (Roun
APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2).pdf	Other-ENROLLEE SURVEY MAILINGS (Roun
APPENDIX B - ENROLLEE SURVEY INSTRUMENTS (Round 2).pdf APPENDIX B - ENROLLEE SURVEY Mailings (Round 2)	IC Document
APPENDIX B - ENROLLEE SURVEY INSTRUMENTS (Round 2).pdf APPENDIX B - ENROLLEE SURVEY Mailings (Round 2)	IC Document
APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2).pdf APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2)	IC Document
APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2).pdf APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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
Other-ENROLLEE SURVEY INSTRUMENTS (Round 2)			APPENDIX B - ENROLLEE SURVEY INSTRUMENTS (Round 2).pdf		Yes	Yes	Fillable Fileable
Other-ENROLLEE SURVEY MAILINGS (Round 2)			APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,616

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	5,616	5,616
Annual IC Time Burden (Hours)	4,212	4,212
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
APPENDIX B - ENROLLEE SURVEY Mailings (Round 2)	APPENDIX B - ENROLLEE SURVEY INSTRUMENTS (Round 2).pdf	04/15/2024
APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2)	APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 2).pdf	04/15/2024

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