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E-Appeal/U.S. Merit Systems Protection Board Appeal Form
OMB: 3124-0017
IC ID: 275476
OMB.report
MSPB
OMB 3124-0017
ICR 202505-3124-002
IC 275476
( )
Documents and Forms
Document Name
Document Type
No Material Changes
Form and Instruction
Security Policy - Warning (May 2025).pdf
Instruction
Online Registration Changes
3124-0017 Online Registration Changes (March 2025).pdf
Form and Instruction
Technical Support Changes
3124-0017 Technical Support (March 2025).pdf
Form and Instruction
Initial Appeal Form Changes
FORM185 (May 2025).pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
No Material Changes
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
N/A
Online Registration Changes
3124-0017 Online Registration Changes (March 2025).pdf
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Technical Support Changes
3124-0017 Technical Support (March 2025).pdf
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Initial Appeal Form Changes
FORM185 (May 2025).pdf
Yes
Yes
Fillable Fileable
Instruction
Security Policy - Warning (May 2025).pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Litigation and Judicial Activities
Subfunction:
Judicial Hearing
Privacy Act System of Records
Title:
Appeals and Case Records
FR Citation:
77 FR 65206
Number of Respondents:
5,000
Number of Respondents for Small Entity:
0
Affected Public:
Federal Government
Percentage of Respondents Reporting Electronically:
75 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
5,000
0
5,000
0
0
0
Annual IC Time Burden (Hours)
0
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.