Information Collection

HPCA Part 3, Individuals Form 10-168c

IC 190587 under ICR 200906-1024-002 · OMB 1024-0009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0009 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-168c HPCA Part 3, Individuals Form 10-168c	Form and Instruction
10-168c HPCA Part 3 HPCA_2009 form.pdf	Form and Instruction

IC Title:

HPCA Part 3, Individuals Form 10-168c

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 67

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
Form and Instruction	10-168c	HPCA Part 3	HPCA_2009 form.pdf		Yes	No	Paper Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 243

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	243	243
Annual IC Time Burden (Hours)	2,066	2,066
Annual IC Cost Burden (Dollars)	190,077	190,077

Documents for IC

table that charts IC Documents
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.