Information Collection

Certification By School Official

IC 13706 under ICR 201601-1240-012 · OMB 1240-0031.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0031 can be found here:

Documents and Forms

Document Name Document Type
Form CM-981 Certification By School Official Form
CM-981 Certification by School Official CM-981 2-16-2016.pdf www.dol.gov/owcp/regs/compliance/cm-981.pdf Form
DOL-ESA 6.doc DOL-ESA 6 IC Document
30 USC 901-902.pdf 30USC901 - 902 IC Document
725.208 - .209.pdf 20CFR725.208 - 209 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Certification By School Official	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 725.209

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CM-981	Certification by School Official	CM-981 2-16-2016.pdf	http://www.dol.gov/owcp/regs/compliance/cm-981.pdf	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/ESA-6	FR Citation: 67 FR 16869

Number of Respondents: 493	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	493	493
Annual IC Time Burden (Hours)	82	82
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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