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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
SIPP 2014 Panel
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
Items Booklet
Items Booklet
A-2014 SIPP Items Booklet - Attachment A Part 1.pdf
Yes
Yes
Fillable Fileable
Form
EHC
EHC
A-2014 SIPP Items Booklet - Attachment A Part 2 (EHC).pdf
Yes
Yes
Fillable Fileable
Other-SIPP-105(L1)2014–Director's Letter
B-SIPP-105(L1)(2014) Attachment B.pdf
Yes
Yes
Fillable Fileable
Other-SIPP-105(L1)(SP)2014–Spanish Director's Letter
C-SIPP-105(L1)(SP)(2014) Attachment C.pdf
Yes
Yes
Fillable Fileable
Other-SIPP-105(L2)2014–Director's Letter with $20 incentive
SIPP-105(L2)(2014) revised incentive statement.pdf
Yes
Yes
Fillable Fileable
Other-SIPP-105(L3)2014–Director's Letter with $40 incentive
SIPP-105(L3)(2014) revised incentive statement.pdf
Yes
Yes
Fillable Fileable
Other-Respondent Rules
F-SIPP Respondent Rules - Attachment F.pdf
Yes
Yes
Fillable Fileable
Other-Respondent Rules (Spanish)
G-SIPP Respondent Rules - Attachment G (Spanish).pdf
Yes
Yes
Fillable Fileable
Other-SIPP Fact Sheet
H-SIPP 101_Factsheet [Attachment H].pdf
Yes
Yes
Fillable Fileable
Other-SIPP Brochure: Health Insurance
I-SIPP_Health Insurance_Brochure Attachment I.pdf
Yes
Yes
Fillable Fileable
Other-SIPP Brochure: Families with Children
J-SIPP_Families with Children Brochure Attachment J.pdf
Yes
Yes
Fillable Fileable
Other-SIPP Brochure: Labor Force and Employment
K-SIPP_Labor Force_Brochure Attachment K.pdf
Yes
Yes
Fillable Fileable
Other-SIPP In the News
L-SIPP in the News_Attachment L.pub
Yes
Yes
Fillable Fileable
Other-SIPP-INF1-2014 Incentive Flyer for Director’s Letter $40
M-sipp_inf1_2014 Attachment M.pdf
Yes
Yes
Fillable Fileable
Other-SIPP-INF2-2014 Incentive Flyer for Director’s Letter $20
N-sipp_inf2_2014 - Attachment N.pdf
Yes
Yes
Fillable Fileable
Other-SIPP PIN letter
O-sipp_pin_2014 Attachment O.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
73,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
73,500
0
73,500
0
0
0
Annual IC Time Burden (Hours)
73,500
0
73,500
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.