Information Collection

ADR Election Form

IC 230727 under ICR 202504-1505-001 · OMB 1505-0262.

Documents and Forms

Document Name Document Type
Form TD F 62-03.11 ADR Election Form Form
Form TD F 62-03.11 ADR Election Form ADR Election Form Form
TD F 62-03.11 ADR Election Form ADR Election Form 62-03.11 04 2025.pdf Form
TD F 62-03.11 ADR Election Form ADR Election Form 62-03.11 04 2025.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ADR Election Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1614

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	TD F 62-03.11	ADR Election Form	ADR Election Form 62-03.11 04 2025.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: Department of the Treasury, Civil Rights, Complaints and Compliance Review Files System of Records Notice	FR Citation: 81 FR 78266

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.

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