OMB
.report
Search
Statement Of Employment And Financial Interests (for Use By State Employees)
STATEMENT OF EMPLOYMENT AND FINANCIAL INTERESTS (FOR USE BY STATE EMPLOYEES)
OMB: 1029-0067
IC ID: 118411
OMB.report
DOI/OSMRE
OMB 1029-0067
ICR 198408-1029-002
IC 118411
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1029-0067 can be found here:
2023-08-01 - Extension without change of a currently approved collection
2020-06-03 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
STATEMENT OF EMPLOYMENT AND FINANCIAL INTERESTS (FOR USE BY STATE EMPLOYEES)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
OSM 23
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,000
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
1,000
0
0
0
0
1,000
Annual IC Time Burden (Hours)
500
0
0
0
0
500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.