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Certification of Prison Records by Prison Officials
Certification of Prison Records by Prison Officials
OMB: 0960-0688
IC ID: 9742
OMB.report
SSA
OMB 0960-0688
ICR 202111-0960-002
IC 9742
( )
Documents and Forms
Document Name
Document Type
Certification of Prison Records Template.pdf
Other-Certification Template - Sampl
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Certification of Prison Records by Prison Officials
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR 422.107
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Certification Template - Sample We Provide to Prisons Upon Request (not always used)
Certification of Prison Records Template.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
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
200,000
0
0
0
0
200,000
Annual IC Time Burden (Hours)
10,000
0
0
0
0
10,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
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.