Information Collection

New Hire States

IC 179587 under ICR 201304-0970-002 · OMB 0970-0166.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0166 can be found here:

Documents and Forms

Document Name Document Type
Form 1 New Hire States Form
1 W4 Record layout W4 record layouts_vfinal(3).doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	New Hire States	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	W4 Record layout	W4 record layouts_vfinal(3).doc		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: Location and Collection System	FR Citation: 70 FR 21200

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10,473,138	10,468,638	4,500
Annual IC Time Burden (Hours)	174,556	-125,594	300,150
Annual IC Cost Burden (Dollars)	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.