Representations to Implement Appropriations Act Provisions on Felony Convictions and Unpaid Federal Tax Liabilities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0494 can be found here:

Documents and Forms

Document Name Document Type
part 1 -- ASD(R&E) memorandum.docx Other-part 1 -- ASD(R&E) memorandum
part 2 -- Attachment 1 to ASD(R&E) memorandum.docx Other-part 2 -- Attachment 1 to ASD(
part 3 -- Attachment 2 to ASD(R&E) memorandum.docx Other-part 3 -- Attachment 2 to ASD(

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Representations to Implement Appropriations Act Provisions on Felony Convictions and Unpaid Federal Tax Liabilities	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-part 1 -- ASD(R&E) memorandum	part 1 -- ASD(R&E) memorandum.docx	Yes	Yes	Fillable Fileable
Other-part 2 -- Attachment 1 to ASD(R&E) memorandum	part 2 -- Attachment 1 to ASD(R&E) memorandum.docx	Yes	Yes	Fillable Fileable
Other-part 3 -- Attachment 2 to ASD(R&E) memorandum	part 3 -- Attachment 2 to ASD(R&E) memorandum.docx	Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	15,000	0	15,000
Annual IC Time Burden (Hours)	1,250	0	1,250
Annual IC Cost Burden (Dollars)	64,800	64,800	0

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.