Information Collection

Employers: Rehabilitation Services Administration (RSA) Payback Information Management System (PIMS)

IC 232924 under ICR 202603-1820-001 · OMB 1820-0617.

Documents and Forms

Document Name Document Type
NA Employers: Rehabilitation Services Administration (RSA) Payback Information Management System (PIMS) Form
Attachment C - RSA PIMS Employment Verification Record 12.10.25.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Employers: Rehabilitation Services Administration (RSA) Payback Information Management System (PIMS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	NA	NA	Attachment C - RSA PIMS Employment Verification Record 12.10.25.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: Privacy Act of 1974; System of Records	FR Citation: 84 FR 32889

Number of Respondents: 1,920	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,920	-1,680	3,600
Annual IC Time Burden (Hours)	480	-121	601
Annual IC Cost Burden (Dollars)	26,400	26,400	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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