View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Customer Service Intake Form
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 301 https://www.askebsa.dol.gov/WebIntake/Home.aspx Yes Yes Fillable Fileable
Form and Instruction 301 https://www.askebsa.dol.gov/WebIntake/Home.aspx?l=es Yes Yes Fillable Fileable
Other-Web Screenshots of Privacy Act and PRA Notices (English) https://www.askebsa.dol.gov/WebIntake/Home.aspx Yes Yes Fillable Fileable
Other-Web Screenshots of Privacy Act and PRA Notices (Spanish) https://www.askebsa.dol.gov/WebIntake/Home.aspx?l=es Yes Yes Fillable Fileable
Form and Instruction 301 https://www.askebsa.dol.gov/WebIntake/Home.aspx Yes Yes Fillable Fileable
Form and Instruction 301 https://www.askebsa.dol.gov/WebIntake/Home.aspx?l=es Yes Yes Fillable Fileable

Income Security General Retirement and Disability

Technical Assistance and Inquiry Files, DOL/PWBA–4  67 FR 16816

5,582 0
   
Individuals or Households
 
   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 5,582 0 0 0 0 5,582
Annual IC Time Burden (Hours) 2,791 0 0 0 0 2,791
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.
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