View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	1090-0008 Feedback Survey Worker Retiree Draft 12AUG2021	Agency IC Tracking Number:	Worker Retiree Draft 12AUG2021

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 and Instruction	Worker Retiree Draft 12AUG2021	Worker Retiree Draft 12AUG2021	1090-0008 Feedback Survey Worker Retiree Draft 12AUG2021.xlsx		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: 20	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	20	0	20	0	0	0
Annual IC Time Burden (Hours)	1	0	1	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Generic Clearance Request Form (PBGC) Worker Retiree Signed	OMB Generic Clearance Request Form (PBGC) Worker Retiree Signed.pdf	09/17/2021
1090-0008 Survey Mapping Doc Worker Retiree Draft 12AUG2021	1090-0008 Survey Mapping Doc Worker Retiree Draft 12AUG2021.docx	09/17/2021

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