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Federal forms, ICRs, and supporting documents

Information Collection

Disabled Dependent Questionnaire

IC 33661 under ICR 202106-3206-003 · OMB 3206-0179.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Disabled Dependent Questionnaire
 
No Modified
 
Required to Obtain or Retain Benefits
 
5 CFR Chp 1 Sect 843.406 - 843.410  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction RI 30-10 Disabled Dependent Questionnaire_MarkUp RI30-010_2018_05_MarkUp.pdf Yes No Fillable Printable
Form and Instruction RI 30-10 Disabled Dependent Questionnaire_Revised RI30-010_2021_09_Revised.pdf Yes No Fillable Printable

General Government Executive Functions

OPM/Central-1  73 FR 15013

2,500 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,500 0 0 0 0 2,500
Annual IC Time Burden (Hours) 2,500 0 0 0 0 2,500
Annual IC Cost Burden (Dollars) 67,187 0 0 67,187 0 0

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