Information Collection

Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84

IC 218495 under ICR 202511-3206-005 · OMB 3206-0268.

Documents and Forms

Document Name Document Type
Form RI120-126 Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 Form and Instruction
Form RI120-126 Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 Form and Instruction
RI120-126 Certification of Qualifying District of Columbia Service RI20-126_2024_03.pdf Form and Instruction
RI120-126 Certification of Qualifying District of Columbia Service RI20-126_2024_03.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.1

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI120-126	Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84	RI20-126_2024_03.pdf	opm.gov	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title: OPM/ Central-1	FR Citation: 73 FR 1503

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,000	0	1,000
Annual IC Time Burden (Hours)	500	0	500
Annual IC Cost Burden (Dollars)	18,010	4,573	13,437

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.

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