"INITIAL CERTIFICATION -- QUALIFIED NONPROFIT AGENCY FOR OTHER SEVERELY HANDICAPPED"

ICR 199203-3037-003

OMB: 3037-0003

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
3037-0003 199203-3037-003
Historical Active 198904-3037-002
CPBSD
"INITIAL CERTIFICATION -- QUALIFIED NONPROFIT AGENCY FOR OTHER SEVERELY HANDICAPPED"
Revision of a currently approved collection   No
Regular
Approved without change 05/21/1992
Retrieve Notice of Action (NOA) 03/04/1992
Approved as amended by CPBOSH's 5/19/92 memorandum to OMB (see OMB #3037-0004 for correspondence).
  Inventory as of this Action Requested Previously Approved
06/30/1995 06/30/1995 05/31/1992
40 0 75
160 0 150
0 0 0

INITIAL CERTIFICATION FORM IS TO DETERMINE THAT THE WORKSHOP IS A QUALIFIED NONPROFIT AGENCY SERVING THE OTHER SEVERELY HANDICAPPED UNDER PUBLIC LAW 92-28.

None
None


No

1
IC Title Form No. Form Name
"INITIAL CERTIFICATION -- QUALIFIED NONPROFIT AGENCY FOR OTHER SEVERELY HANDICAPPED" COM 402

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 40 75 0 -158 123 0
Annual Time Burden (Hours) 160 150 0 45 -35 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/04/1992


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