Information Collection

Application for Employment as a Locally Employed Staff or Family Member

IC 190750 under ICR 202512-1405-001 · OMB 1405-0189.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-174 Application for Employment as a Locally Employed Staff or Family Member Application for Employment as a Locally Employed Staff or Family Member	Form and Instruction
Screenshots 2019.docx	Other-Screenshots
DS-174 Application for Employment as a Locally Employed Staff o DS-0174.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form and Instruction	DS-174				Yes	Yes	Fillable Fileable
Other-Screenshots					Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-1,000,000	1,000,000
Annual IC Time Burden (Hours)	-750,000	750,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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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