Information Collection

Petition for Recertification Section 76.916

IC 151176 under ICR 199412-3060-036 · OMB 3060-0562.

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Information Collection (IC) Details

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IC Title:	Petition for Recertification Section 76.916	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: 1,300	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,300	1,300
Annual IC Time Burden (Hours)	3,250	3,250
Annual IC Cost Burden (Dollars)	0	0

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Title	Document	Date Uploaded

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