Information Collection

Individuals/Households

IC 259304 under ICR 202605-0584-001 · OMB 0584-0686.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FNA 775 EmpowHR/Person Model Non-Data Employee Sheet Individuals/Households	Form
Appendix E EmpowHr Screenshots (2).docx	Other-Appendix E EmpowHr Screenshots
FNA 775 EmpowHR/Person Model Non-Data Employee Sheet Appendix B FNS 775 EmpowHR Person Model-1.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	FNA 775				No		Paper Only
Other-Appendix E EmpowHr Screenshots					Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records

Title: USDA/OP-1 Personnel and Payroll System

FR Citation: 63 FR 4213

Number of Respondents: 62

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	62	62
Annual IC Time Burden (Hours)	31	31
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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