Information Collection

Informed Consent (Paper)

IC 258843 under ICR 202610-0960-007 · OMB 0960-0833.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CJCC Informed Consent Form- Revised.docx	Other-CJCC Informed Consent Form
CJCC Informed Consent Form- Current.docx Informed Consent Form - Current	IC Document

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
Other-CJCC Informed Consent Form					No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10	-80	90
Annual IC Time Burden (Hours)	4	-11	15
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Informed Consent Form - Current		10/16/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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