Information Collection

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

IC 28987 under ICR 200702-3037-003 · OMB 3037-0003.

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IC Title:

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

Agency IC Tracking Number:

402-02-27-2007

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 41 CFR 51-4.2(d) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	30	0	30
Annual IC Time Burden (Hours)	600	570	30
Annual IC Cost Burden (Dollars)	30,000	30,000	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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