View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Beneficiaries	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Introductory Letter English			Appendix C1. Introductory Letter (English).docx		Yes	Yes	Paper Only
Other-Introductory Letter Spanish			Appendix C2. Introductory Letter (Spanish).docx		Yes	Yes	Paper Only
Other-Telephone Introductory Script English			Appendix C3 Telephone Survey Introduction Script (English).docx		No		Paper Only
Other-Telephone Survey Script Spanish			Appendix C4 Telephone Survey Introduction Script (Spanish).docx		No		Paper Only
Other-Reminder Voicemail Script English			Appendix C5 Reminder Voicemail Script (English).docx		No		Paper Only
Other-Reminder Voicemail Script Spanish			Appendix C6 Reminder Voicemail Script (Spanish).docx		No		Paper Only
Other-Reminder Letter English			Appendix C7. Reminder Letter with Paper Questionnaire (English).docx		No		Fillable Fileable
Other-Reminder Letter Spanish			Appendix C8. Reminder Letter with Paper Questionnaire (Spanish).docx		No		Fillable Fileable
Other-Confidentiality Agreement			Appendix A1 Data Collector Confidentiality Agreement.docx		Yes	Yes	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 10 %

	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	400	0	0	0	0	400
Annual IC Time Burden (Hours)	100	0	0	0	0	100
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
60-day	60-dayFederal Register, Volume 82 Issue 187 (Thursday, September 28, 2017).htm	01/26/2018
30day	30-day Federal Register, Volume 82 Issue 247 (Wednesday, December 27, 2017).htm	01/26/2018

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