Information Collection

Notice of Recurrence

IC 13870 under ICR 202005-1240-006 · OMB 1240-0009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0009 can be found here:

Documents and Forms

Document Name Document Type
Form CA-2a Notice of Recurrence Form and Instruction
CA-2a Notice of Recurrence ca-2a (003).pdf www.dol.gov/owcp/regs/compliance/ca-2a.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notice of Recurrence	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 10.104

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CA-2a	Notice of Recurrence	ca-2a (003).pdf	http://www.dol.gov/owcp/regs/compliance/ca-2a.pdf	Yes	Yes	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/GOVT-1	FR Citation: 81 FR 47418

Number of Respondents: 133	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 11 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	133	-156	289
Annual IC Time Burden (Hours)	67	-78	145
Annual IC Cost Burden (Dollars)	69	-81	150

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.