Information Collection Request

Application for Employment as a Locally Employed Staff or Family Member

ICR 202512-1405-001 · OMB 1405-0189 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form DS-174 Employment Application for Locally Employed Staff or Family Member Form and Instruction New Available
Form DS-174 Application for Employment as a Locally Employed Staff or Family Member Form and Instruction Removed Available
LegalAuthorities_112025.docx Supplementary Document Uploaded 2025-12-09 Available
LegalAuthorities_2022.docx Supplementary Document Uploaded 2022-02-11 Available
Supporting-Statement_30day_112025.docx Supporting Statement A Uploaded 2025-12-09 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
278374 Application for Employment as a Locally Employed Staff or Family Member Form and Instruction NewEmployment Application for Locally Employed Staff or Family Member
190750 Application for Employment as a Locally Employed Staff or Family Member Form and Instruction RemovedApplication for Employment as a Locally Employed Staff or Family Member
190750 Application for Employment as a Locally Employed Staff or Family Member Other-Screenshots Removed

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2026
600,000 1,000,000
150,000 750,000
0 0





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1
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IC Title Form No. Form Name
Application for Employment as a Locally Employed Staff or Family Member DS-174
Application for Employment as a Locally Employed Staff or Family Member DS-174

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 600,000 1,000,000 0 -400,000 0 0
Annual Time Burden (Hours) 150,000 750,000 0 -600,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No