Information Collection

Nondiscrimination On The Basis Of Age In Federally-assisted Programs Of Doi

IC 118862 under ICR 198706-1084-002 · OMB 1084-0027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1084-0027 can be found here:

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Information Collection (IC) Details

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IC Title:	NONDISCRIMINATION ON THE BASIS OF AGE IN FEDERALLY-ASSISTED PROGRAMS OF DOI	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	4,000	4,000
Annual IC Cost Burden (Dollars)	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.