View Information Collection (IC)

View Information Collection (IC)

IC Title:	Disclosure of Information related to Potential Violations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 22 CFR 120-130 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DS-7787	Disclosure of Information Related to Potential Violations	[FINAL] 1405-0179 DS-7787 Form v3.8.pdf		Yes	Yes	Fillable Fileable
Instruction			(Final) 1405-0179 DS-7787 Disclosure Form Instructions.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

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	1,500	0	200	0	0	1,300
Annual IC Time Burden (Hours)	15,000	0	2,000	0	0	13,000
Annual IC Cost Burden (Dollars)	52,500	0	52,500	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.