Information Collection

State Participation Program Dot 2066

IC 142456 under ICR 198208-2130-001 · OMB 2130-0509.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2130-0509 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	STATE PARTICIPATION PROGRAM DOT 2066	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.	Available Electronically?	Can Be Submitted Electronically?
Form	6180-58	No	No
Form	58A, 59	No	No
Form	59A, 68	No	No
Form	68A, 69	No	No
Form	65, 65A	No	No
Form	67, 5	No	No
Form	5A, 10	No	No
Form	29, 29A	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	13,080	13,050	30
Annual IC Time Burden (Hours)	9,592	9,442	150
Annual IC Cost Burden (Dollars)	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.