Application for Domestic Indemnity

Application for Domestic Indemnification

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3135-0123 can be found here:

Documents and Forms

Document Name Document Type
Domestic Indemnity Guidelines.doc www.nea.gov Instruction

Information Collection (IC) Details

IC Title:	Application for Domestic Indemnity	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 1160

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Domestic Indemnity Guidelines.doc	www.nea.gov	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Exhibition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	100	0	0	0	0	0
Annual IC Time Burden (Hours)	4,500	0	0	0	0	0
Annual IC Cost Burden (Dollars)	180,000	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.