View Information Collection (IC)

View Information Collection (IC)

IC Title:	HIRE Vets Medallion Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR part 2011, subpart B (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
Other-Account Registration Page			HIRE-Vets-Account-Registration.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011LG	HIRE Vets Application Large Employer Gold (Paper)	HIRE Vets Application Large Employer Gold (Paper) VETS-1011LG.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011LG	HIRE Vets Application Large Employer Gold (Screenshot)	HIRE Vets Application Large Employer Gold (Screenshot) VETS-1011LG.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011LP	HIRE Vets Application Large Employer Platinum (Paper)	HIRE Vets Application Large Employer Platinum (Paper) VETS-1011LP.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011LP	HIRE Vets Application Large Employer Platinum (Screenshot)	HIRE Vets Application Large Employer Platinum (Screenshot) VETS-1011LP.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011MP	HIRE Vets Application Medium Employer Gold (Paper)	HIRE Vets Application Medium Employer Gold (Paper) VETS-1011MG.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011MG	HIRE Vets Application Medium Employer Gold (Screenshot)	HIRE Vets Application Medium Employer Gold (Screenshot) VETS-1011MG.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011MP	HIRE Vets Application Medium Employer Platinum (Paper)	HIRE Vets Application Medium Employer Platinum (Paper) VETS-1011MP.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011MP	HIRE Vets Application Medium Employer Platinum (Screenshot)	HIRE Vets Application Medium Employer Platinum (Screenshot) VETS-1011MP.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011SG	HIRE Vets Application Small Employer Gold (Paper)	HIRE Vets Application Small Employer Gold (Paper) VETS-1011SG.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011SG	HIRE Vets Application Small Employer Gold (Screenshot)	HIRE Vets Application Small Employer Gold (Screenshot) VETS-1011SG.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011SP	HIRE Vets Application Small Employer Platinum (Paper)	HIRE Vets Application Small Employer Platinum (Paper) VETS-1011SP.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	VETS-1011SP	HIRE Vets Application Small Employer Platinum (Screenshot)	HIRE Vets Application Small Employer Platinum (Screenshot) VETS-1011SP.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,136	Number of Respondents for Small Entity: 1,011

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

Percentage of Respondents Reporting Electronically: 95 %

	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	34,711	0	0	0	0	34,711
Annual IC Time Burden (Hours)	59,571	0	0	0	0	59,571
Annual IC Cost Burden (Dollars)	0	0	0	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.