OMB control number

Pre-Hire Conflict of Interest Screening Form

OMB 7100-0379 · FRS.

OMB 7100-0379

The FR 28c form collects information from external applicants applying to the Board regarding certain financial interests or business relationships held by the applicant and by their immediate family members, as well as the external applicant’s involvement with certain outside organizations to determine whether a conflict of interest may exist, which could impact the applicant’s ability to fulfill the responsibilities associated with the position for which they have applied.

The latest form for Pre-Hire Conflict of Interest Screening Form expires 2023-08-31 and is listed under ICR 202007-7100-006.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
FR28c_20200813_omb.pdfSupporting Statement A
FR 28c Other-Draft Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202007-7100-006 New collection (Request for a new OMB Control Number) 2020-08-13 Approved without change