Committee Form 402 -- Initial Certification - Qualified Nonprofit Agency Serving People Who Are Severely Disabled

ICR 200202-3037-002

OMB: 3037-0003

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
3037-0003 200202-3037-002
Historical Active 199812-3037-002
CPBSD
Committee Form 402 -- Initial Certification - Qualified Nonprofit Agency Serving People Who Are Severely Disabled
Extension without change of a currently approved collection   No
Regular
Approved without change 03/27/2002
Retrieve Notice of Action (NOA) 02/01/2002
  Inventory as of this Action Requested Previously Approved
03/31/2005 03/31/2005 04/30/2002
50 0 50
50 0 50
0 0 0

The initial certification form is used to ensure that nonprofit agencies desiring to participate in the JWOD program as providers of products or services meet the requirements of the program.

None
None


No

1
IC Title Form No. Form Name
Committee Form 402 -- Initial Certification - Qualified Nonprofit Agency Serving People Who Are Severely Disabled 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 50 50 0 0 0 0
Annual Time Burden (Hours) 50 50 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
02/01/2002


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