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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
IHS Background Investigation of Individuals in Positions Involving Regular Contact with or Control Over Indian Children
Agency IC Tracking Number:
0917-0028
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
42 CFR 136.401-418
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0917-0028
Final Addendum to Declaration for Federal Employment (OF 360) Form, IHS Child Care Positions
Final_Addendum to Declaration for Federal Employment (OF 306) FORM1 OMS TSS REV 08182015 (1).doc
http://www.ihs.gov/Jobs/index.cfm?module=support
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
3,000
0
0
0
0
3,000
Annual IC Time Burden (Hours)
600
0
0
0
0
600
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Declaration for Federal Employment (OPM OF 306; OMB No. 3206-0182)
OMB Form No. 3206-0182 0306[1].pdf
06/11/2012
60 Day Federal Register Notice for 0917-0028, Addendum to Declaration for Federal Employment, Child Care and Indian Child Care Worker Positions
FINAL Draft 0917-0028 FR 60 Day Notice rg 6-4-15.docx
09/11/2015
30 Day Federal Register Notice for OMB No. 0917-0028, Addendum to Declaration for Federal Employment, Child Care and Indian Child Care Worker Positions
FINAL 0917-0028 FR 30 Day Notice 8-05-2015 with dra edit 08-06-15 - accepted by T.Clay.docx
09/11/2015
OMB No. 0917-0028, Supporting Statement for IHS Background Investigation of Individuals in Positions Involving Regular Contact with or Control Over Indian Children
FINAL OMB No. 0917-0028 Supporting Statement, 9-24-2015.doc
09/24/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.