Information Collection

Application for Employment as a Locally Employed Staff or Family Member

IC 190750 under ICR 201710-1405-003 · OMB 1405-0189.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0189 can be found here:

Documents and Forms

Document Name Document Type
Form DS-174 Application for Employment as a Locally Employed Staff or Family Member Form and Instruction
DS-174 Application for Employment as a Locally Employed Staff o ds174 - DRAFT - 11-07-2017.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Employment as a Locally Employed Staff or Family Member	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 and Instruction	DS-174	Application for Employment as a Locally Employed Staff or Family Member	ds174 - DRAFT - 11-07-2017.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	40,000	40,000
Annual IC Time Burden (Hours)	40,000	40,000
Annual IC Cost Burden (Dollars)	12,500	12,500

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.