Information Collection

252.204-7017 Disclosure

IC 238323 under ICR 202609-0750-001 · OMB 0750-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0750-0002 Collection Instruments.docx	Other-Contract Clauses

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: 48 CFR 252.204-7017(e)

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
Other-Contract Clauses					Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 345

Number of Respondents for Small Entity: 237

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	15,525	0	15,525
Annual IC Time Burden (Hours)	46,575	0	46,575
Annual IC Cost Burden (Dollars)	3,084,662	230,080	2,854,582

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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