Information Collection

Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5

IC 11552 under ICR 202103-1076-002 · OMB 1076-0160.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0160 can be found here:

Documents and Forms

Document Name Document Type
Form 4432 Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5 Form and Instruction
4432 Verification of Indian Preference for Employment in BIA F 1076-0160 INDIAN PREF form app and instructions.docx www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm Form and Instruction
4432 Verification of Indian Preference for Employment in BIA F 1076-0160 INDIAN PREF form app and instructions.docx www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm Form and Instruction
n/a (Attachment to Family History Chart Family History Form 2011.doc www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm Form
n/a (Attachment to Family History Chart Family History Form 2011.doc www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Verification of Indian Preference for Employment in BIA and IHS, 25 CFR 5	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4432	Verification of Indian Preference for Employment in BIA and IHS	F 1076-0160 INDIAN PREF form app and instructions.docx	http://www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm	Yes	No	Paper Only
Form	n/a (Attachment to 4432)	Family History Chart	Family History Form 2011.doc	http://www.bia.gov/WhatWeDo/ServiceOverview/TribalGov/index.htm	Yes	No	Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: OS-79, General Personnel Records	FR Citation: 64 FR 20010

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,000	0	5,000
Annual IC Time Burden (Hours)	2,500	0	2,500
Annual IC Cost Burden (Dollars)	7,400	480	6,920

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.