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Information Collection Review Data on RegInfo.gov
OMB Control Number ICR Reference Number Agency Tracking Number
Agency
Sub Agency
Text (Majority of Text Boxes)
Type of Request New collection (Request for a new OMB Control Number) Extension without change of a currently approved collection Revision of a currently approved collection Reinstatement without change of a previously approved collection Reinstatement with change of a previously approved collection Existing collection in use without an OMB Control Number No material or nonsubstantive change to a currently approved collection Date Type Date Range:(mm/dd/yyyy) Received Concluded Act By Expired Discontinued Expiring From To	ICR Status Received in OIRA Active Historical Active Historical Inactive PreApproved
Conclusion Action Comment filed on Interim Final Rule Comment filed on Interim Final Rule and continue Approved without change Approved with change Disapproved Disapproved and continue Preapproved Comment filed on proposed rule Comment filed on proposed rule and continue Withdrawn Withdrawn and continue Not subject to PRA Not subject to PRA and continue Improperly submitted Improperly submitted and continue Delegated Returned - Improperly Submitted Returned to Agency for Reconsideration Returned - Outside Generic Clearance Approved	Type of Review Regular Emergency Delegated
Certification (a) It is necessary for the proper performance of agency functions (b) It avoids unnecessary duplication (c) It reduces burden on small entities (d) It uses plain, coherent, and unambiguous language...... (e) Its implementation will be consistent and compatible...... (f) It indicates the retention periods for recordkeeping requirements (g) It informs respondents of the information called for...... (h) It was developed by an office that has planned and allocated...... (i) It uses effective and efficient statistical survey methodology...... (j) It makes appropriate use of information technology	ICR Ended Due To Discontinued Disapproved and Not Continued Expired New Approval Transfer ended OMB Ctl No.
Burden Range: Hours: Between   and Dollars: Between   and Responses: Between   and Respondents: Between   and Respondents-Small Entities: Between   and Obligation to Respond Mandatory Required to Obtain or Retain Benefits Voluntary	ICRs that   Are generic Privacy impact assessment   Are preapproved Affect small entities   Received public comments Relate to proposed rulemaking   Employ statistical methods Relate to interim/final rulemaking   Include common form(s) Include form(s)   Include collections available electronically   Include collections that can be submitted electronically   Relate to other documents for OIRA review
Form Number	Form Name
Burden Due To Reporting Record Keeping Third Party Disclosure Reporting and Record Keeping Reporting and Third Party Disclosure Record Keeping and Third Party Disclosure All Three Types	Affected Public Businesses or other for-profits Farms Federal Government Individuals or Households Not-for-profit institutions Private Sector State, Local, and Tribal Governments
Line of Business	Subfunction