ANNUAL CERTIFICATION, QUALIFIED NONPROFIT AGENCY FOR THE BLIND

ICR 199408-3037-001

OMB: 3037-0001

Federal Form Document

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ICR Details
3037-0001 199408-3037-001
Historical Active 199203-3037-002
CPBSD
ANNUAL CERTIFICATION, QUALIFIED NONPROFIT AGENCY FOR THE BLIND
Revision of a currently approved collection   No
Regular
Approved without change 11/23/1994
Retrieve Notice of Action (NOA) 08/08/1994
Approved under the condition, as agreed to by the Committee, that the Committee make the following revisions to maximize the usefulness of this form, or explain why such revisions are not necessary: -- collect data on the number of sighted people who are employed under item 5; -- clarify the meaning of Health and Welfare cash payments in the instructions to item 6E; and -- clarify the measure of sales requested in item 7 (dollars, percent, or volume).
  Inventory as of this Action Requested Previously Approved
07/31/1997 07/31/1997 04/30/1995
76 0 80
228 0 240
0 0 0

THE ANNUAL CERTIFICATION FORM IS USED TO INSURE THAT NONPROFIT AGENCIE PARTICIPATING IN THE COMMITTEE'S PROGRAM ARE MEETING THE LEGAL REQUIREMENTS OF THE JWOD ACT. THE COLLECTED DATA IS ALSO USED TO MEASURE THE EFFECTIVENESS OF THE PROGRAM.

None
None


No

1
IC Title Form No. Form Name
ANNUAL CERTIFICATION, QUALIFIED NONPROFIT AGENCY FOR THE BLIND COM 403

  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 76 80 0 -4 0 0
Annual Time Burden (Hours) 228 240 0 -12 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
08/08/1994


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