Information Collection

International Centenarian Project

IC 191770 under ICR 202603-0960-012 · OMB 0960-0780.

Documents and Forms

Document Name Document Type
Face-to-Face Interview Worksheet.pdf Other-Interview Worksheet
MNUP Worksheet Screen Shots.pdf Other-Interview Worksheet

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	International Centenarian Project	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 422.135 20 CFR 416.204(b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview Worksheet			Face-to-Face Interview Worksheet.pdf		Yes	No	Printable Only
Other-Interview Worksheet			MNUP Worksheet Screen Shots.pdf		Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,220	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,220	4,026	194
Annual IC Time Burden (Hours)	1,407	1,194	213
Annual IC Cost Burden (Dollars)	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.

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