Information Collection

Application Forms And Sample Questions For Pace

IC 176688 under ICR 198110-3206-011 · OMB 3206-0078.

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Information Collection (IC) Details

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IC Title:	APPLICATION FORMS AND SAMPLE QUESTIONS FOR PACE	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.	Available Electronically?	Can Be Submitted Electronically?
Form	1281	No	No
Form	1203-F	No	No
Form	CSC-1279,	No	No
Form	1281, AND	No	No
Form	1203-F	No	No
Form	OPM1279	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	35,000	-165,000	200,000
Annual IC Time Burden (Hours)	35,000	-165,000	200,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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