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

Documents and forms in this information collection
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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	NA				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 %

table that charts list of burden
	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

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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