Information Collection

Supplemental Qualifications Statements

IC 176606 under ICR 198002-3206-004 · OMB 3206-0038.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0038 can be found here:

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Information Collection (IC) Details

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IC Title:	SUPPLEMENTAL QUALIFICATIONS STATEMENTS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CSC 1170				No	No
Form	OPM 1170				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,046,310	920	1,045,390
Annual IC Time Burden (Hours)	227,928	493	227,435
Annual IC Cost Burden (Dollars)	0	0	0

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Title	Document	Date Uploaded

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