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Federal forms, ICRs, and supporting documents

Information Collection Request

SUPPLEMENTAL APPLICATION FORM (SUPPLEMENT TO SF-171 FOR JOB APPLICANTS)

ICR 198103-0584-002 · OMB 0584-0084 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
163359 SUPPLEMENTAL APPLICATION FORM (SUPPLEMENT TO SF-171 FOR JOB APPLICANTS) Migrated
ICR Details
0584-0084 198103-0584-002
Historical Active 198007-0584-005
USDA/FNS
SUPPLEMENTAL APPLICATION FORM (SUPPLEMENT TO SF-171 FOR JOB APPLICANTS)
No material or nonsubstantive change to a currently approved collection   No
Emergency 03/19/1981
Approved with change 03/19/1981
Retrieve Notice of Action (NOA) 03/19/1981
  Inventory as of this Action Requested Previously Approved
10/31/1984 10/31/1984 10/31/1984
13,500 0 13,500
6,750 0 6,750
0 0 0
PROVIDES SUPPLEMENTAL INFORMATION NOT COVERED BY SF-171.
None
None
No
1
IC Title Form No. Form Name
SUPPLEMENTAL APPLICATION FORM (SUPPLEMENT TO SF-171 FOR JOB APPLICANTS)
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 13,500 13,500 0 0 0 0
Annual Time Burden (Hours) 6,750 6,750 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/19/1981