View Information Collection (IC)

View Information Collection (IC)

IC Title:	Certification By School Official	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 725.209

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CM-981	Certification by School Official	CM-981 2-16-2016.pdf	http://www.dol.gov/owcp/regs/compliance/cm-981.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/ESA-6	FR Citation: 67 FR 16869

Number of Respondents: 493	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	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	493	0	0	0	0	493
Annual IC Time Burden (Hours)	82	0	0	0	0	82
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
DOL-ESA 6	DOL-ESA 6.doc	02/07/2007
30USC901 - 902	30 USC 901-902.pdf	02/07/2007
20CFR725.208 - 209	725.208 - .209.pdf	02/07/2007

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